| NPI | 1376206623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY STOSKOPF Credentialing Assistant Manager 316-209-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2021-10-14 |