| NPI | 1083682835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E GILLIAM President 919-467-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: NC 000460726) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2013-09-06 |