| NPI | 1851843296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MAGUS Treasurer 307-358-9464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |