| NPI | 1932899580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA IVY GUSTUS CEO 410-517-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |