| NPI | 1700983988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE P CRISMAN Manager 409-842-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: TX 0082279) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |