| NPI | 1295542991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J. DESTEFANE Manager 314-682-5368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2024-12-16 |