| NPI | 1033842646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN FENTON Credentialing Manager 615-854-3409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2022-07-01 |