Organization
MCNICHOLAS, LLC
Active
Other names
Vital Care of Boise
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M. MCNICHOLAS (MANAGING MEMBER)
(623) 670-1625
Entity
Organization
Contact information
Practice address
12828 W LASALLE ST STE 101, BOISE, ID 83713-1517
(623) 670-1625
(208) 579-5662
Mailing address
12828 W LASALLE ST STE 101, BOISE, ID 83713-1517
(623) 670-1625
(205) 579-5662
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Enumeration date
05/24/2022
Last updated
11/06/2025
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