| NPI | 1023253895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB BETHEL PATTERSON Owner 434-792-6387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: VA 5734) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2022-10-12 |