| NPI | 1326475104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERIBERTO I MATA Manager 520-409-1875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |