| NPI | 1548249386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA J HATHAWAY Credentialing Officer 260-408-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 50001907A) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2015-06-01 |