| NPI | 1659237501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN WAGONER President 301-292-4982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2026-01-05 |
| Last Update Date | 2026-01-05 |