| NPI | 1285772343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY ANN RUSSELL Senior Director Of Payor Relations 629-252-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 218051407) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-04-17 |