| NPI | 1083785935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY KEITH STEWART Asst. Adminstrator 864-226-5054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: SC 0386640001) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |