Healthcare Provider Details

I. General information

NPI: 1770339558
Provider Name (Legal Business Name): MEDICAP CPAP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 W CHERRY LN
MERIDIAN ID
83642-1137
US

IV. Provider business mailing address

2790 W CHERRY LN STE 150
MERIDIAN ID
83642-1106
US

V. Phone/Fax

Practice location:
  • Phone: 208-805-1070
  • Fax: 208-805-1077
Mailing address:
  • Phone: 208-805-1070
  • Fax: 208-805-1077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DEVIN TRONE
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 208-805-1070