Organization
AXIOM MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW F FAHY (PRESIDENT)
(208) 867-9479
Entity
Organization
Contact information
Practice address
390 W COLCHESTER DR, EAGLE, ID 83616-5864
(208) 939-8079
Mailing address
390 W COLCHESTER DR, EAGLE, ID 83616-5864
(208) 939-8079
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/05/2010
Last updated
01/05/2010
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