| NPI | 1184509499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS ANTHONY MORENO Manager 307-201-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-11-20 |