| NPI | 1609793553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JACKSON CEO 929-410-5754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2026-07-01 |
| Last Update Date | 2026-07-21 |