| NPI | 1023476512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY NEINO Optum National Credentialing 763-910-9022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2026-06-11 |