| NPI | 1871716118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE FINCHER Acting Program Manager 208-334-4935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |