| NPI | 1619561164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN H PARK President/CEO 317-580-6307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-02-25 |