| NPI | 1508908021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A MALLOY Administrative Assistant 208-463-3103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2010-06-16 |