Organization
PREMIUM CHOICE HOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE HAMPTON (OWNER)
(208) 313-6607
Entity
Organization
Contact information
Practice address
1970 E 17TH ST, SUITE 207, IDAHO FALLS, ID 83404-8014
(208) 313-6607
Mailing address
1970 E 17TH ST, SUITE 207, IDAHO FALLS, ID 83404-8014
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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