| NPI | 1720949886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA ACOSTA Credentialing Coordinator 859-303-8803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-11-19 |
| Last Update Date | 2025-11-19 |