Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Voluntary or Charitable |
251V00000X | 61 | Voluntary Health or Charitable Agency[1] |
| NPI Number | 1659103935 |
| LBN Legal business name | MARTIN SUPPORTIVE SERVICES |
| Authorized official | DEREK MARTIN - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/15/2024 |
| Last updated | 08/15/2024 - More than a year ago |
| Identifiers | n/a |
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