| NPI | 1790964914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE NUTTY Program Coordinator 317-329-7146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2008-04-20 |