| NPI | 1083914501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI GOLDMAN Director Of Contracting 317-333-6033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 69000381A) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 69000381A) |
| Enumeration Date | 2010-10-31 |
| Last Update Date | 2011-12-16 |