| NPI | 1881715571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN RUSKIN Owner 772-340-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 860) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: FL 860) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 860) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |