| NPI | 1811094782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT MACIAS Owner 909-514-1087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 101224) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-04-08 |