| NPI | 1134319692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE GRACE DOMINGUEZ-YOST President 856-778-3707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NJ 1362148) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2008-02-22 |