| NPI | 1750772869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUS PAPANIKOLAS Owner 208-871-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID DME3776) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2018-06-18 |