| NPI | 1033575378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNETTA TRAYLOR Administrator 502-596-6063 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2025-05-06 |