| NPI | 1407073182 |
|---|---|
| Doing Business As | CARDIOSOM OF PEORIA |
| Entity Type | Organization |
| Authorized Contact | KEVIN GREISL COO President 317-706-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IL 203.000894) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-10-25 |