4t Medical Supply
Durable Medical Equipment & Medical Supplies in Rigby, ID. Organization (NPI-2).
NPI number1861693368
StatusActive
Last updated in NPPESJun 13, 2008
Details
- NPI
- 1861693368
- Entity type
- Organization (NPI-2)
- Legal business name
- 4t Medical Supply
- Organization subpart
- No
- Enumeration date
- May 30, 2007
- Last updated
- Jun 13, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
147 N 4090 ERigby, ID 83442-5888
Phone 208-745-9497
Mailing address
147 N 4090 ERigby, ID 83442-5888
Phone 208-745-9497
Authorized official
Odila Eugenia Conica
Owner
2087459497
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