| NPI | 1194701243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN GLICK President 808-245-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: HI W2056705401) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2008-03-28 |