Healthcare Provider Details

I. General information

NPI: 1750815510
Provider Name (Legal Business Name): IDEAL SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 E 65TH N
IDAHO FALLS ID
83401-5653
US

IV. Provider business mailing address

1317 E 65TH N
IDAHO FALLS ID
83401-5653
US

V. Phone/Fax

Practice location:
  • Phone: 208-241-6525
  • Fax:
Mailing address:
  • Phone: 208-241-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number StateID

VIII. Authorized Official

Name: ERIC WALKER
Title or Position: PRESIDENT
Credential:
Phone: 208-241-6525