| NPI | 1154532109 |
|---|---|
| Other Name | EPSDT GROUP FOR MA |
| Entity Type | Organization |
| Authorized Contact | PAM GARMON Business Office Manager 270-651-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |