| NPI | 1760993968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP ROSS VASTA Owner 754-778-7147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2026-01-06 |