| NPI | 1669470118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: LA CRT.LT1901) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2025-10-15 |