| NPI | 1043827694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL JAMES INGRAM Owner 877-401-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |