| NPI | 1851677827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN KARL BOSH Owner/Manager 208-251-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: ID DME16726) |
| Enumeration Date | 2011-10-22 |
| Last Update Date | 2011-10-22 |