Organization
CEDAR MOUNTAIN RESPIRATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY GREENE CRT (CEO)
(208) 762-4480
Entity
Organization
Contact information
Practice address
77 W COMMERCE DR, HAYDEN, ID 83835-9221
(208) 762-4480
(208) 762-4462
Mailing address
77 W COMMERCE DR, HAYDEN, ID 83835-9221
(208) 762-4480
(208) 762-4462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
ID
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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