| NPI | 1588998124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA D NEWCOMB Director/Owner 208-249-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID W82971) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2019-04-02 |