| NPI | 1093380222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA HALL Credentialing Contract Specialist 619-640-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-06-28 |