| NPI | 1376790410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON JAMAR PREMO Manager 602-476-3359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |