| NPI | 1912327321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN TOMAS POLVOS Secretary 509-733-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |