| NPI | 1962415661 |
|---|---|
| Doing Business As | ACTIVE LIFE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY SOUZA President 888-525-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 0201003378) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2015-05-13 |