| NPI | 1821290057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY KRUSE CEO 217-545-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2023-07-19 |