| NPI | 1245929215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE M BEDROSIAN-GREGORIAN Sole Proprietor 978-884-2519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-04 |