| NPI | 1790530525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA DIPZINSKI CEO 269-220-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WD1100X Registered Nurse, Dialysis, Peritoneal |
| Additional Taxonomies | 163WH0500X Registered Nurse, Hemodialysis |
| 2472R0900X | |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-04-23 |