| NPI | 1619577665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNMARIE BUCKINGHAM Compliance Supervisor 234-200-1379 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 171WV0202X Contractor, Vehicle Modifications | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2023-11-03 |