Organization
LIVE WELL CPAP AND MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ERIC PETERSON RPSGT (OWNER)
(208) 971-2888
Entity
Organization
Contact information
Practice address
11513 W FAIRVIEW AVE STE 106, BOISE, ID 83713-7887
(208) 971-2888
Mailing address
11513 W FAIRVIEW AVE STE 106, BOISE, ID 83713-7887
(208) 971-2888
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/05/2019
Last updated
04/15/2026
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