| NPI | 1538802954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DALE CLARK Operations Manager 877-217-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |