| NPI | 1043012735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIEL ANSLEY JOHNSON Manager 347-712-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-09-21 |