Organization
ORTHOMEDICAL, INC
Active
Organization
ORTHOMEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAYLEY HALL (OWNER/PRESIDENT)
(208) 785-4595
Entity
Organization
Contact information
Practice address
1053 W BRIDGE ST, BLACKFOOT, ID 83221-1915
(208) 785-4595
(208) 785-4595
Mailing address
PO BOX 1127, BLACKFOOT, ID 83221-1127
(208) 785-4595
(208) 785-4595
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DME200
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805979000
—
ID
Enumeration date
11/22/2006
Last updated
12/07/2021
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