Provider Demographics
NPI:1710288261
Name:THE JB BENZIE CO. INC
Entity Type:Organization
Organization Name:THE JB BENZIE CO. INC
Other - Org Name:THE EASY CHAIR STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-866-3473
Mailing Address - Street 1:5407 N SAMSON AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-1954
Mailing Address - Country:US
Mailing Address - Phone:208-866-3473
Mailing Address - Fax:
Practice Address - Street 1:4489 N DRESDEN PL
Practice Address - Street 2:#104
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83714-5004
Practice Address - Country:US
Practice Address - Phone:208-866-3473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies