| NPI | 1942690680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM C MILBY Treasury 207-465-8220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY MG0110) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2022-12-01 |