| NPI | 1053395475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL K MBANG Director 225-774-7476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-08-22 |