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Organization

DIRECT CONNECT IDAHO LLC

Active
Other names
Mobility Mart Plus
Organization subpart
No

Provider details

NPI number
Authorized official
ZECHARIAH BAKER (PRESIDENT)
(208) 314-2631
Entity
Organization

Contact information

Practice address
5584 W OLD RANCH ST, GARDEN CITY, ID 83714-1839
(208) 314-2631
Mailing address
2976 E STATE ST STE 120-1039, EAGLE, ID 83616-6377
(208) 314-2631

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Enumeration date
12/17/2024
Last updated
12/17/2024
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