Organization
4T MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ODILA EUGENIA CONICA (OWNER)
(208) 745-9497
Entity
Organization
Contact information
Practice address
147 N 4090 E, RIGBY, ID 83442-5888
(208) 745-9497
Mailing address
147 N 4090 E, RIGBY, ID 83442-5888
(208) 745-9497
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/30/2007
Last updated
06/13/2008
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