| NPI | 1679587653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANT MOSHANG Controller 410-910-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0085511) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: TX 25303) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0012206) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-03-07 |