| NPI | 1508876996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE SHARP Pharmacy Insurance Administrator 775-356-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: NV 3316320) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |