| NPI | 1851124671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATTA SHAHID Agent 618-554-3683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-08-29 |