| NPI | 1285042267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL PATRICK LORDEN Owner 267-686-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA 6000008526) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2015-01-13 |