| NPI | 1225087828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN RONALD SCHRADER President 909-447-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-08-22 |