| NPI | 1023110236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE CELESTINE OMALU Administrator 334-745-5751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 672) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |