| NPI | 1811657588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY AWAD Pharmacy Manager 551-221-5670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2021-12-22 |