Snake River Medical Services, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

DME249 Issued in ID

Legal business name

SNAKE RIVER MEDICAL SERVICES, INC.

Practice address

526 Shoup Ave W Ste B
Twin Falls, ID 83301-5050

Phone

(208) 735-2252

Fax

(208) 735-3917

NPI assigned

Nov 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carla Ellen Miller, CRT, RPSGT

Title

Owner

Phone

(208) 735-2252

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1124193040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 SHOUP AVE W STE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015050",
            "telephone_number": "208-735-2252",
            "fax_number": "208-735-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 SHOUP AVE W STE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015050",
            "telephone_number": "208-735-2252",
            "fax_number": "208-735-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNAKE RIVER MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-735-2252",
        "authorized_official_credential": "CRT, RPSGT"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "ID",
            "license": "DME249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807127500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trevor Parker Smith, D.D.S.
• Smiths Food & Drug Centers Inc
• Kelly Smothers, LPC, ICADC,SAP
• Snake River Ear, Nose & Throat PC
• Snake River Gastroenterology Labs, L.L.C.
• Snake River Urology, P.C.
• Snake River Wound Care and Hyperbarics LLC
• Vanessa Snow, AUD
• Soaring Free PLLC
• Eisa Hamid Sobbi, PHARMD

• Oxygen Equipment & Supplies (DME) in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Oxygen Equipment & Supplies (DME) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.