| NPI | 1972583078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WADLE COO 512-217-5198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-02-27 |