| NPI | 1518845114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALTON GADAL Member 928-756-9171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-22 |