| NPI | 1972080570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNMARIE BUCKINGHAM Compliance COO Rdinator, Paralegal 234-200-1379 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2020-10-22 |