MEDICARE: NORCO, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)
4	335E00000X	Prosthetic/Orthotic Supplier
5	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619031234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORCO, INC

Provider Business Mailing Address
First Line	:	1125 W AMITY RD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83705-5412
Country	:	US
Telephone Number	:	208-336-1643
Fax Number	:

Provider Business Practice Location Address
First Line	:	329 W MAIN ST
Second Line	:
City	:	GRANGEVILLE
State	:	ID
Zip	:	83530-1917
Country	:	US
Telephone Number	:	208-983-0390
Fax Number	:	208-983-0658

Authorized Official
Title or Position	:	EXE VICE PRESIDENT MEDICAL
Name	:	MR. BRENT SEWARD
Credential	:
Telephone Number	:	208-336-1643

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	03/28/2022

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Directions to “NORCO, INC ” Practice Location

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