| NPI | 1982179040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA PITTS Credentialing & Licensing Manager 888-345-1780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2026-04-07 |