Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers | |
Long Term Care Hospital |
282E00000X | A0[7] | Hospital-Long-Term (PPS excluded) |
| NPI # | 1891086914 |
| LBN Legal business name | DIVINE MEDICAL SUPPLY, INCORPORATED |
| Authorized official | FEMI ABATAN - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/23/2011 |
| Last updated | 04/23/2011 - About 15 years ago |
| Identifiers | n/a |
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