| NPI | 1992709307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALAN DUTCHER Member 860-793-6843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2020-08-22 |