| NPI | 1679568786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICITAS C. ESPIRITU Member 304-720-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies (Licence: WV 0353710-001) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-08-22 |