| NPI | 1639678816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 1499) |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2025-10-15 |