| NPI | 1124379425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE M. GUPTA President 847-681-8947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |