| NPI | 1578545687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER CHARLES STIELAU Director 610-323-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: PA PP414200L) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: PA PP414200L) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2015-03-16 |