| NPI | 1770875197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER FAY CEO 267-750-9622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2024-01-23 |