| NPI | 1639478589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA A GORKEN VP, Fps 727-532-1355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2018-01-26 |