| NPI | 1871904870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMBERTO FONG VP 732-337-6492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NV 2000266424) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |