| NPI | 1689077042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 1356) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2025-10-13 |