| NPI | 1225272404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD EUGENE MOON CFO 937-206-8944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2009-05-01 |