| NPI | 1003511296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERIE ARCHIE Authorized Official 559-451-3675 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2024-10-23 |