| NPI | 1174669295 |
|---|---|
| Other Name | MOSES LAKE LOCATION |
| Entity Type | Organization |
| Authorized Contact | JIM JEWELL CEO 509-547-2246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA ATP6816) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2015-12-21 |