Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers |
| NPI # | 1578836136 |
| LBN Legal business name | MEDULTRA SUPPLIES, LLC |
| Authorized official | SALOMON MIZRAHI - (DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/13/2012 |
| Last updated | 02/13/2012 - About 14 years ago |
| Identifiers | n/a |
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