Organization
NORCO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT SEWARD (EXECUTIVE VICE PRESIDENT MEDICAL)
(208) 336-1643
Entity
Organization
Contact information
Practice address
1439 DALLES MILITARY RD, WALLA WALLA, WA 99362-9544
(509) 525-1066
(509) 522-2361
Mailing address
1125 W AMITY RD, BOISE, ID 83705-5412
(208) 336-1643
(208) 343-4615
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447679402
—
ID
05
—
1447679402
—
WA
05
—
500680090
—
OR
Enumeration date
04/07/2014
Last updated
03/28/2022
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