| NPI | 1285865410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HODGE Member 316-269-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2009-08-05 |