| NPI | 1710991641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANT MOSHANG Controller 410-910-1578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0085868) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2008-12-01 |