| NPI | 1477939387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE CONN Vice President 740-456-4363 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY HME00941) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: KY MG0900) | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2021-08-17 |