| NPI | 1528054830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORI DANIEL SHAVER Vice President 208-232-9392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: ID DME197) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2020-08-22 |