| NPI | 1891349924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA D ERIKSON General Manager 208-715-9997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2019-07-26 |