| NPI | 1114399011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY A ROSE Owner 276-466-8119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 1101001369) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-12-15 |