| NPI | 1629748264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco/ AO 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2025-10-13 |