NPI: 1316975402 · ROANOKE, VA 24018 · Nursing Facility Supplies (DME) · NPI assigned 06/29/2006
| Authorized Official | MOORE, TYLER (MANAGING MEMBER) |
| NPI Enumeration Date | 06/29/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 20 | $201.33 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 20 | 12 | $201.33 |