NPI | 1689034837 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENT SEWARD EVP Medical 208-336-1643 |
Organization Subpart ? | No |
Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
335E00000X Prosthetic/Orthotic Supplier | |
Enumeration Date | 2016-03-01 |
Last Update Date | 2022-03-29 |