| NPI | 1841336732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLESHIA A SHULTS-STARK Billing Center Manager 317-865-4409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: IL 038) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-07-21 |