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General NPI Number Information
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NPI Number | 1407976798
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF IDAHO
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 129 WEST THIRD ST.
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City | MOSCOW
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State | ID
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Zip | 83843-0000
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Country | US
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Telephone | 208-885-3771
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Fax | 208-885-3628
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Provider Business Mailing Address
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Address Line | 129 WEST THIRD ST.
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City | MOSCOW
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State | ID
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Zip | 83843-0000
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Country | US
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Telephone | 208-885-3771
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Fax | 208-885-3628
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Authorized Official
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Title or Position | INFORMATION SPECIALIST
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Name | MRS. SUSAN P HOUSE
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Credential |
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Telephone | 208-885-3771
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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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