| NPI | 1033447644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco/ AO 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2025-10-15 |