| NPI | 1538469051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI GOLDMAN Director Of Contracting 317-333-6033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IN 69000636A) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 69000636A) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 69000636A) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2010-10-31 |
| Last Update Date | 2015-05-13 |