| NPI | 1215231311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA PRAIRIE Director 800-998-6359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-01-04 |