| NPI | 1922108737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMAINE A. THOMAS Manager 702-547-6017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NV 1000042-424) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-03-29 |