| NPI | 1073759007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER KELECHI EKEH Md 219-472-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: IN 0131070630) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: IN 0131070630) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2008-12-22 |