KINGHORN MEDICAL LLC NPI 1821436718

NPI Information

NPI: 1821436718
Provider Name: KINGHORN MEDICAL LLC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Specialization: Customized Equipment
Entity Type: Organization
Doing Business As: MOUNTAIN BRACE SYSTEMS
Address: 248 S COLE RD
BLDG #7
BOISE, ID
ZIP 83709
Phone: (208) 350-3092

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NPI Details

KINGHORN MEDICAL LLC is a customized equipment durable medical equipment medical supplies in Boise, ID. KINGHORN MEDICAL LLC NPI is 1821436718. The provider is registered as an organization entity type.
The provider Is Doing Business As Mountain Brace Systems.

The provider's business location address is:

248 S COLE RD
BLDG #7
BOISE, ID
ZIP 83709-934
Phone: (208) 350-3092
Fax: (208) 901-8185

The provider's authorized official is Jake Kent Kinghorn .
The authorized official title is Owner and has the following contact phone number (208) 350-3092.

The enumeration date for this NPI number is 6/13/2013 and was last updated on 9/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IDTPID009228	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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