| NPI | 1861462244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY ANN RUSSELL Senior Director Of Payor Relations 629-252-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL 596) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 596) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2024-04-17 |