| NPI | 1639407760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM MCCORD President 208-287-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: ID DME423) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2023-03-13 |