| NPI | 1568442440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JACOBCHICK Director 701-323-8470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: ND 606) | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-08-22 |