| NPI | 1942047931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVAN SANIKIDZE CEO 929-481-5096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| 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 | 2024-07-09 |
| Last Update Date | 2024-07-09 |