Organization
VALLEY MEDICAL SHOPPE INC
Active
Parent organization
VALLEY MEDICAL SHOPPE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY MEDICAL SHOPPE INC
Authorized official
MR. GARY W AIMAN (OWNER)
(208) 356-7913
Entity
Organization
Contact information
Practice address
1350 PARKWAY DR, STE 26, BLACKFOOT, ID 83221-1657
(208) 782-0456
(208) 782-0457
Mailing address
146 N 2ND E, REXBURG, ID 83440-1620
(208) 356-7913
(208) 356-9532
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
DME244
ID
Other
Enumeration date
05/27/2006
Last updated
09/10/2009
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