| NPI | 1841754363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA SPARKS Credentialing Mgr 317-941-7338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |