| NPI | 1073093746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN BUSSARD Owner 916-868-9513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: CA 103-114781) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |