| NPI | 1073320115 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | RUSTAM ABDAEV President 656-233-6894 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies | 
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | 
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2024-12-12 | 
| Last Update Date | 2024-12-12 |