| NPI | 1952686164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON C HODGE President 720-458-4887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Additional Taxonomies | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |