| NPI | 1508400458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY WAYNE CARROLL Compliance Officer/Admin Support 712-796-3695 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2020-05-13 |