| NPI | 1720645807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD BEACH Business Manager 888-766-5103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2024-02-15 |