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General NPI Number Information
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NPI Number | 1134323306
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND MEDICAL SUPPLY CO LLC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 7112 E CANTERBURY LN
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City | NAMPA
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State | ID
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Zip | 83687-9432
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Country | US
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Telephone | 800-743-3179
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Fax | 800-367-6163
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Provider Business Mailing Address
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Address Line | 7112 E CANTERBURY LN
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City | NAMPA
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State | ID
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Zip | 83687-9432
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Country | US
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Telephone | 800-734-3179
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Fax | 800-367-6163
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Authorized Official
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Title or Position | MEMBER
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Name | NIKOL H MCKEAN
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Credential |
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Telephone | 800-743-3179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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