| NPI | 1720306889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL MOMATE BIABENE Administrator 702-629-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2015-11-17 |