| NPI | 1629175021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BENSON Interim CEO/Medical Director 317-580-6304 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-06-02 |