| NPI | 1962531426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUSSALESI Cco/ AO 484-246-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 1365 - 045) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2024-09-23 |