Provider Demographics
NPI:1356126841
Name:NORCO INC
Entity type:Organization
Organization Name:NORCO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-509-3088
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:208-336-1643
Mailing Address - Fax:
Practice Address - Street 1:12610 E MIRABEAU PKWY STE 500
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1450
Practice Address - Country:US
Practice Address - Phone:509-455-9385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier