| NPI | 1770954471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCK MENGISTU President 424-331-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 74463) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2017-04-19 |