| NPI | 1821584350 |
|---|---|
| Former Legal Business Name | NOVAM-NUTRITION LLC |
| Entity Type | Organization |
| Authorized Contact | TINA MADSEN SANDSTROM CEO 855-416-6826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |