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Organization
SNAKE RIVER MEDICAL SERVICES, INC.
Active
Organization
SNAKE RIVER MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA ELLEN MILLER CRT, RPSGT (OWNER)
(208) 735-2252
Entity
Organization
Contact information
Practice address
526 SHOUP AVE W STE B, TWIN FALLS, ID 83301-5050
(208) 735-2252
(208) 735-3917
Mailing address
526 SHOUP AVE W STE B, TWIN FALLS, ID 83301-5050
(208) 735-2252
(208) 735-3917
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
DME249
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807127500
—
ID
Enumeration date
11/24/2006
Last updated
09/21/2011
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