| NPI | 1427405075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLEY KAY BAITY Medicare Biller 217-422-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |