Provider Demographics
NPI:1033377817
Name:PETERSON OXIMETRY SERVICES
Entity Type:Organization
Organization Name:PETERSON OXIMETRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT
Authorized Official - Phone:208-461-2824
Mailing Address - Street 1:625 TRIUMPH DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:ID
Mailing Address - Zip Code:83644-6022
Mailing Address - Country:US
Mailing Address - Phone:208-461-2824
Mailing Address - Fax:208-585-6292
Practice Address - Street 1:106 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-5564
Practice Address - Country:US
Practice Address - Phone:208-461-2824
Practice Address - Fax:208-585-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty