| NPI | 1528313079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK TRACY JOHNSTON Vice President 320-358-0987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: MN 355872) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |