| NPI | 1497867055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS ENTREKIN President 856-401-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NJ 0079490) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |