Healthcare Provider Details

I. General information

NPI: 1174720924
Provider Name (Legal Business Name): DARGREEN POWER SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 MAIN ST
GOODING ID
83330-1305
US

IV. Provider business mailing address

442 MAIN ST
GOODING ID
83330-1305
US

V. Phone/Fax

Practice location:
  • Phone: 208-595-4290
  • Fax: 208-934-4820
Mailing address:
  • Phone: 208-595-4290
  • Fax: 208-934-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateID

VIII. Authorized Official

Name: DEAN RICHARDSON
Title or Position: OWNER
Credential:
Phone: 208-595-4290