MEDICARE: SCOTT SERVICE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1669468765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 151
Second Line	:
City	:	MALAD CITY
State	:	ID
Zip	:	83252-0151
Country	:	US
Telephone Number	:	208-766-2588
Fax Number	:	208-766-2588

Provider Business Practice Location Address
First Line	:	4701 W HIGHWAY 38
Second Line	:
City	:	MALAD CITY
State	:	ID
Zip	:	83252-6615
Country	:	US
Telephone Number	:	208-766-2588
Fax Number	:	208-766-2588

Authorized Official
Title or Position	:	GENERAL MANAGER / PARTNER
Name	:	BRYAN P SCOTT
Credential	:
Telephone Number	:	208-766-3350

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	08/22/2020

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Directions to “SCOTT SERVICE ” Practice Location

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