| NPI | 1558364141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM HAYS President 208-882-5536 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 065CP) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 065CP) |
| 332S00000X Hearing Aid Equipment (Licence: ID H244) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: ID 065CP) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2009-12-18 |