| NPI | 1164657748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONZELLA LYNNE FLETCHER Owner 951-736-6160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 331L00000X Blood Bank |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |