| NPI | 1538305198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL C MACK CEO 708-333-2498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2009-12-29 |