| NPI | 1114975620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH HMEL.11025) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-10-14 |