| NPI | 1073573325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PABLO MEDINA CEO 386-532-7594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 32:02615) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1791) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-08-22 |