Organization Name: | VALLEY MEDICAL SHOPPE INC |
NPI Number: | 1063469187 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY W AIMAN (OWNER) |
Mailing Address: | 146 N 2nd E Rexburg |
State: | ID US |
Postal Code: | 834401620 |
Phone Number: | 2083567913 |
Fax Number: | |
NPI Enumeration Date: | 05/27/2006 |
NPI Last Update Date: | 04/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | DME224 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |