Provider Demographics
NPI:1346803335
Name:REHAB SYSTEMS CALDWELL LLC
Entity Type:Organization
Organization Name:REHAB SYSTEMS CALDWELL LLC
Other - Org Name:COYOTE PROSTHETICS & ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-342-4104
Mailing Address - Street 1:427 N CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1439
Mailing Address - Country:US
Mailing Address - Phone:208-342-4104
Mailing Address - Fax:208-342-4106
Practice Address - Street 1:504 N 10TH AVE STE A
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-2925
Practice Address - Country:US
Practice Address - Phone:208-453-6404
Practice Address - Fax:208-453-6402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier