| NPI | 1730599374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE O BODWELL Member 317-538-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 30005122a) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: IN 30005122a) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IN 30005122a) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2015-07-12 |