| NPI | 1053660373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALEMHA SIMPSON Organizer 347-433-8727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA CO112991) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-08-31 |