| NPI | 1629384664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAILAN OLIQUINO PINEDA Medical It Administrator 479-750-7463 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2022-07-21 |