Healthcare Provider Details
I. General information
NPI: 1346803335
Provider Name (Legal Business Name): REHAB SYSTEMS CALDWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2019
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
504 N 10TH AVE STE A
CALDWELL ID
83605-2925
US
IV. Provider business mailing address
427 N CURTIS RD
BOISE ID
83706-1439
US
V. Phone/Fax
- Phone: 208-453-6404
- Fax: 208-453-6402
- Phone: 208-342-4104
- Fax: 208-342-4106
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COLETTE
BROWN
Title or Position: ADMIN MANAGER
Credential:
Phone: 208-342-4104