| NPI | 1518066414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA MARIE MCCORD President 208-287-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID DME233) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-03-13 |