| NPI | 1083722912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY TEWMEY Billing Specialist 502-368-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 191111) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: KY 191111) |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: KY 191111) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY 191111) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: KY 191111) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |