| NPI | 1184233769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DOCKSTADER President/COO 303-587-4025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-08-05 |