| NPI | 1174862791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA FONDER Treasurer 605-215-1889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |