Organization
DYNAMED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER HUNT (PRESIDENT)
(208) 322-5055
Entity
Organization
Contact information
Practice address
3036 E LANARK ST, UNIT B, MERIDIAN, ID 83642-5918
(208) 322-5055
(208) 322-8033
Mailing address
3036 E LANARK ST, UNIT B, MERIDIAN, ID 83642-5918
(208) 322-5055
(208) 322-8033
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152453
REGENCE BLUE SHIELD OF ID
ID
05
—
213648
—
OR
Enumeration date
06/21/2006
Last updated
08/22/2020
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