| NPI | 1578635439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MERL DICKINSON Owner 530-355-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |