| NPI | 1730414533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA MELNIKOVA Vice President 747-900-4290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 76234) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2022-07-21 |