NPI | 1245221092 |
---|---|
Entity Type | Organization |
Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000000780) |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
335E00000X Prosthetic/Orthotic Supplier | |
Enumeration Date | 2005-11-01 |
Last Update Date | 2024-03-26 |