Provider Demographics
NPI:1043448400
Name:IDAHO HOME HEALTH & HOSPICE
Entity type:Organization
Organization Name:IDAHO HOME HEALTH & HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATION/CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-734-4061
Mailing Address - Street 1:826 EASTLAND DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6858
Mailing Address - Country:US
Mailing Address - Phone:208-734-4061
Mailing Address - Fax:
Practice Address - Street 1:423 IDAHO ST
Practice Address - Street 2:
Practice Address - City:GOODING
Practice Address - State:ID
Practice Address - Zip Code:83330-1258
Practice Address - Country:US
Practice Address - Phone:208-934-4842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002539400Medicaid
ID002558500Medicaid
ID002496000Medicaid
ID137014Medicare Oscar/Certification
ID002558500Medicaid