| NPI | 1295745776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE SHARP Pharmacy Insurance Adminstrator 775-356-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: NV 3316085) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |