| NPI | 1962402057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS SHARPE Vice President 292-435-4571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: FL ph1174) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-03-29 |