| NPI | 1801284732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIGENE L ALLEN Owner 619-718-2721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 305S00000X Point of Service (Licence: CA 182029) |
| 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies | |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |