| NPI | 1629767066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY ANN RUSSELL Senior Director Of Payor Relations 629-252-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2026-03-17 |