| NPI | 1356962021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYA TUCKER Administrator 856-200-8341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-07-01 |