| NPI | 1174505440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH EDWARD WIESE General Manager 830-775-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0082294) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2008-08-20 |