Organization
K2RED L.L.C.
Active
Other names
HOME IV SERVICES & MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SCOTT FUCHS RPH (MEMBER)
(208) 735-8700
Entity
Organization
Contact information
Practice address
526 SHOUP AVE W STE L, TWIN FALLS, ID 83301-5050
(208) 735-8700
(208) 734-7389
Mailing address
526 SHOUP AVE W STE L, TWIN FALLS, ID 83301-5050
(208) 735-8700
(208) 734-7389
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
1333LS
ID
3336H0001X
Home Infusion Therapy Pharmacy
1333LS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805156800
—
ID
05
—
805182700
—
ID
Enumeration date
10/03/2006
Last updated
04/25/2008
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