| NPI | 1417357609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L WATTS Legal & Compliance Assc. 502-489-9449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT CSW.000315) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |