| NPI | 1487350419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD JOHNSON Executive Vice President 909-977-1945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |