| NPI | 1326046863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R LOPEZ Owner/Operator 928-684-5313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: AZ 20020638) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2014-10-02 |