Local City Search for Medical Equipment Suppliers KOOTENAL HEALTH
Specialty Pharmacy
Coeur D Alene, Idaho
Provider NPI: 1073835591
Organization Information:Organization Name: KOOTENAL HEALTH
Practice Location:
700 W IRONWOOD DR COEUR D ALENE, ID 83814 US
Tel: 208-625-5670 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
700 W IRONWOOD DR COEUR D ALENE, ID 83814 US
Tel: 208-625-5670 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 3336S0011X | Suppliers Pharmacy Specialty Pharmacy | ||
| N | 332B00000X | Suppliers Durable Medical Equipment & Medical Supplies | ||
| N | 333600000X | Suppliers Pharmacy | ||
| Y | 3336C0002X | Suppliers Pharmacy | ID | 1198LS |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1073835591 | ID | 05 | |
| PK | 2124398 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
