| NPI | 1003133240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVONNDA S RAINES President 317-388-9150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 0102114331) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2011-10-10 |