| NPI | 1750670808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN MARIE MOORE President Of Corporation 217-351-4106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 046006881) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |