Organization
VALLEY HOME OXYGEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEANDRA OLSON R.N. (OWNER)
(208) 847-1700
Entity
Organization
Contact information
Practice address
762 1/2 WASHINGTON ST, MONTPELIER, ID 83254-1422
(208) 847-1700
(208) 847-1578
Mailing address
762 1/2 WASHINGTON ST, MONTPELIER, ID 83254-1422
(208) 847-1700
(208) 847-1578
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
DME126
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002719500
—
ID
Enumeration date
03/29/2006
Last updated
08/22/2008
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