| NPI | 1104839356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP GERARD AMEDEE Owner 985-872-1469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 0C13075) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-22 |