| NPI | 1770641995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MD R2106) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-08-29 |