| NPI | 1508747346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WADE Billing Manager 667-268-3661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-09-09 |