| NPI | 1861876401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE ANN WOODS Credentialing/Contract Manager 909-907-0783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |