| NPI | 1033473830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY COSTELLO CFO 574-647-8545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 69000126A) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2018-04-19 |