| NPI | 1447559687 |
|---|---|
| Doing Business As | ACTIVE LIFE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY A SOUZA President 888-525-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2013-07-21 |