Healthcare Provider Details

I. General information

NPI: 1255874491
Provider Name (Legal Business Name): LOVING CARE & MORE HOME MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E. MULLAN AVE. SUITE A
OSBURN ID
83849
US

IV. Provider business mailing address

PO BOX 847
OSBURN ID
83849-0847
US

V. Phone/Fax

Practice location:
  • Phone: 208-556-0101
  • Fax:
Mailing address:
  • Phone: 208-556-0101
  • 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: MR. MICHAEL L HULL
Title or Position: CHIEF EXECUTIVE MANAGER
Credential: R.N.
Phone: 208-556-0101