| NPI | 1083404529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KOCH Authorized Official 307-459-0694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-27 |