Healthcare Provider Details

I. General information

NPI: 1669669248
Provider Name (Legal Business Name): IDAHO HOME HEALTH & HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 CITATION WAY # 2
HAILEY ID
83333-5183
US

IV. Provider business mailing address

826 EASTLAND DR
TWIN FALLS ID
83301-6858
US

V. Phone/Fax

Practice location:
  • Phone: 208-788-6030
  • Fax:
Mailing address:
  • Phone: 208-734-4061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEBBIE OSBORN
Title or Position: VP OPERATIONS/CFO
Credential:
Phone: 208-734-4061