| NPI | 1013410539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL ACOSTA President 920-634-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2018-03-11 |
| Last Update Date | 2018-03-11 |