| NPI | 1578620530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CLARK President 740-201-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-02-14 |