| NPI | 1871516203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY KIPPER Manager, Billing & Collections 800-211-9136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA HMDR#48442) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 43291) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 48442) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: CA HMDR#48442) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-05-19 |