| NPI | 1053610907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTA' ERELL WATERS Owner 912-508-8058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |