| NPI | 1053934745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY RACHELLE BEDELL Member 660-429-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |