| NPI | 1235922584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M DEMING Coding Credentialing Manager 860-549-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-06-27 |