| NPI | 1558827535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PENN Director 877-603-4226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |