| NPI | 1265461032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2024-05-01 |