| NPI | 1679280549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA PITTS Credentialing Manager 888-345-1780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2026-06-28 |