| NPI | 1104434976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA ERVIN Director 803-223-9362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 332BD1200X Durable Medical Equipment & Medical Supplies Dialysis Equipment & Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2021-04-21 |