| NPI | 1861664328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA L MELLOTT Member 307-334-0177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2009-07-27 |