| NPI | 1790846020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL MILES BLATSTEIN Owner 772-380-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 121954071029341) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |