| NPI | 1891210548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE KING Billing Manager 631-569-4192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-08-03 |