| NPI | 1629831722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH GEORGE CEO 267-368-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |