| NPI | 1861375412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZEEM KHAN Authorized Official 307-400-2370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-07-30 |