| NPI | 1174632921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARROD MARSHALL SHUPE Director Of Finance And Operations 315-701-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347E00000X Transportation Broker (Licence: NY 02903150) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 02519304) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-05-02 |