| NPI | 1659379899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MCCORMACK Treasurer/Secretary 480-830-7314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 07-693941-E) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2020-08-22 |