| NPI | 1770109357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M DEMING Credentiaing Managerl 860-549-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2023-03-20 |