| NPI | 1235693854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRINCE V SAMUEL Manager 469-235-3173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-12-27 |