| NPI | 1114929437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JACKSON Owner 510-222-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA DME02720F) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-08-22 |