| NPI | 1316746076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB MCINTYRE Authorized Official 628-218-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-05-27 |