| NPI | 1932464401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE LOUISE HANNAH Owner 951-221-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |