Organization
NORCO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT SEWARD (EXECUTIVE VICE PRESIDENT MEDICAL)
(208) 336-1643
Entity
Organization
Contact information
Practice address
1303 S SILVERSTONE WAY, MERIDIAN, ID 83642
(208) 898-0202
(208) 888-2266
Mailing address
1125 W AMITY RD, BOISE, ID 83705-5412
(208) 336-1643
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DME159
ID
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
DME159
ID
332BX2000X
Oxygen Equipment & Supplies (DME)
DME159
ID
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002324701
—
ID
01
—
8059173-00
MEDICAID - HOME MODIFICATION
ID
01
—
8081284-01
MEDICAID - PERS
ID
Enumeration date
12/11/2006
Last updated
05/09/2022
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