| NPI | 1598700296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS L HENDRICKSON Vice President 952-936-3274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH19494) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: FL PH19494) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |