Organization
INTERMOUNTAIN OCULAR PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM F MURANO II BCO (PRESIDENT)
(208) 378-8200
Entity
Organization
Contact information
Practice address
2995 N COLE RD, STE 115, BOISE, ID 83704-5965
(208) 378-8200
(208) 378-9357
Mailing address
2995 N COLE RD, STE 115, BOISE, ID 83704-5965
(208) 378-8200
(208) 378-9357
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005600854
—
MT
05
—
278130
—
OR
Enumeration date
08/10/2006
Last updated
08/22/2020
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