| NPI | 1497508055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL GRAY Compliance Officer 347-970-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |