NPI | 1659719193 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENT SEWARD Exe Vice President Medical 208-336-1643 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
335E00000X Prosthetic/Orthotic Supplier | |
Enumeration Date | 2013-06-06 |
Last Update Date | 2022-03-29 |