| NPI | 1912717455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA VANDERPOOL Compliance Officer 937-771-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |