| NPI | 1770040693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ORA EDWARDS III Owner 208-875-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251F00000X Home Infusion |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2025-01-06 |