| NPI | 1881885093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA WAGNER Owner 870-723-3148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2009-07-23 |