| NPI | 1275740318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD ANTHONY GORDON Owner 906-632-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MI 00194T) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-03-06 |