Rachelle Bosh

Individual provider Active NPI Customized Equipment (DME) · Rigby, ID

NPI 1467049569 · NPPES record last updated Dec 23, 2020

Key facts

NPI
1467049569
Entity type
Individual (NPI type 1)
Primary specialty
Customized Equipment (DME) 332BC3200X
Practice address
4156 E 421 N
Rigby, ID 83442-5516
Phone
(208) 251-1042
Fax
(208) 745-8739
NPI assigned
Dec 23, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Yes

Addresses

Primary practice location

4156 E 421 N
Rigby, ID 83442-5516

Mailing address

4156 E 421 N
Rigby, ID 83442-5516
Phone (208) 251-1042

Other providers in Rigby, ID

All providers in Rigby, ID · Customized Equipment (DME) in Idaho

Sources for this page

Verify at the official NPI Registry.