| NPI | 1790987444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIY KHOMYAK President 605-439-2771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 20167370) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |