| NPI | 1376529412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN GLICK President 808-245-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: HI PHY598) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-08-22 |