| NPI | 1285228635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE BASSLER Credentialing Specialist 907-339-2455 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-12-21 |