Provider Demographics
NPI:1891230322
Name:NORCO, INC
Entity Type:Organization
Organization Name:NORCO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT, MEDICAL
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-336-1643
Mailing Address - Street 1:1125 W AMITY RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5412
Mailing Address - Country:US
Mailing Address - Phone:208-363-1643
Mailing Address - Fax:208-343-4615
Practice Address - Street 1:807 NW WAREHOUSE WAY
Practice Address - Street 2:D1
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-9350
Practice Address - Country:US
Practice Address - Phone:541-447-0427
Practice Address - Fax:541-447-0419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORNPC-0001968332B00000X, 332BC3200X, 332BX2000X
332BX2000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier