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IDAHO STATE VETERAN HOME - LEWISTON

Medical Equipment Supplier Yellow Pages

Lewiston, Idaho

Provider NPI: 1689687261

Organization Information:
Organization Name:  IDAHO STATE VETERAN HOME - LEWISTON


Practice Location:
821 21ST AVE  LEWISTON, ID 83501 US
Tel: 208-799-3422  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336L0003XSuppliers
Pharmacy
Long Term Care Pharmacy
ID1042HP

Other Provider Identifiers:

IssuerNumberStateType
NCPDP NUMBER1307102ID01
DEA NUMBERBI397435901
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




JOBS ID - Page 1



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