| NPI | 1730109588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WADLE COO 512-217-5198 |
| Organization Subpart ? | |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO B0028507A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-02-27 |