NPI | 1992164883 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL BRETT STOUTE Chief Compliance Officer 337-500-1977 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203001824) |
Enumeration Date | 2016-02-19 |
Last Update Date | 2025-08-01 |