| NPI | 1164735379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER LAWRENCE KATEN CFO 772-631-3140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: CO PDO-401) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CO PDO-401) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: CO PDO-401) | |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2025-01-13 |