| NPI | 1386689610 |
|---|---|
| Doing Business As | PROVENA HOME MEDICAL EQUIPMENT |
| Entity Type | Organization |
| Authorized Contact | MARGARET C GLEASON President CEO 815-806-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 11580037) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |