| NPI | 1790064004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH M. RICCIARDI Physician 870-423-3774 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR E1571) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |