| NPI | 1720004096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY DEGNER Home Care Manager 765-447-1935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 60002663A) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-10-11 |