Full of Life 5580
Organization Active NPI Durable Medical Equipment & Medical Supplies · Idaho Falls, ID
NPI 1447580428 · NPPES record last updated Jan 13, 2010
Key facts
- NPI
- 1447580428
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 003513710-S (ID)
- Legal business name
- FULL OF LIFE 5580
- Practice address
- 697 E 1600 N
Idaho Falls, ID 83402-5752 - Phone
- (208) 521-0155
- Fax
- (208) 357-7516
- NPI assigned
- Jan 13, 2010
- Organization subpart
- No
Authorized official
- Name
- Willard R Price
- Title
- Owner
- Phone
- (208) 521-0155
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 003513710-S | ID | Yes |
Addresses
Primary practice location
697 E 1600 N
Idaho Falls, ID 83402-5752
Mailing address
697 E 1600 N
Idaho Falls, ID 83402-5752
Phone (208) 521-0155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003513710-S | Other | ID | SELLER'S PERMIT |
Other providers in Idaho Falls, ID
- Fresenius Medical Care Snake River, LLC
- Connor Daniel Fried
- Brenda M Fritz
- Yazmin J Frodin
- Caryl M Frugoli
- Full Spectrum Psychology LLC
- Joshua A Fuller
- Fullmer Counseling LLC
- Lorenza Fullmer
- Nathan James Fullmer
All providers in Idaho Falls, ID · Durable Medical Equipment & Medical Supplies in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.