| NPI | 1760857585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESU BROWN Vice President 618-623-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-04 |