Organization
GREAT WESTERN DISTRIBUTION OF IDAHO, LLC
Active
Organization
GREAT WESTERN DISTRIBUTION OF IDAHO, LLC
Active
Other names
Custom Home Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
SHERMAN LEIBOW (OWNER)
(208) 342-4800
Entity
Organization
Contact information
Practice address
480 E FRANKLIN RD, SUITE 108, MERIDIAN, ID 83642-2919
(208) 888-7561
(208) 287-3695
Mailing address
480 E FRANKLIN RD, SUITE 108, MERIDIAN, ID 83642-2919
(208) 888-7561
(208) 287-3695
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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