| NPI | 1639055841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE JENKINS Authorized Official 469-915-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-08-13 |