| NPI | 1750391140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALMA D TREJO Pharmacy Insurance Administrator 775-785-7396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: NV 3316031) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-09-23 |