| NPI | 1881366482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY HALTIGAN Director Of Revenue Circle 877-856-3774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-01-19 |