| NPI | 1104048974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA JEAN MCADAMS Member 608-355-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: 1822145) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |