| NPI | 1588695795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG CRAWFORD Authorized Official 859-441-8876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: KY MG0539) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY MG0539) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY MG 0539) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-10-04 |