| NPI | 1902647886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE AMICK Manager 888-315-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-09-09 |