| NPI | 1912250879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUGBENGA OBAWEYA Store Manager 347-777-5061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |