| NPI | 1497991780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L BRUNET Store Manager 916-965-4352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 332B00000X) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2010-07-14 |