| NPI | 1811769136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DESTEFANO Program Manager 603-206-5725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |