| NPI | 1861062507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CHRYSOSTOME Owner 800-304-1755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-10-04 |