Organization
EASTERN IDAHO MEDICAL SUPPLY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S TAYLOR (PRESIDENT)
(208) 589-2897
Entity
Organization
Contact information
Practice address
3800 TAYLORVIEW LN, AMMON, ID 83406-8145
(208) 589-2897
Mailing address
3800 TAYLORVIEW LN, AMMON, ID 83406-8145
(208) 589-2897
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/01/2008
Last updated
06/01/2008
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