| NPI | 1033396171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM SMITH Manager 502-634-1721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 22152) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2017-06-08 |