| NPI | 1134647670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE SEMENIUTA Regional Director 424-465-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |