| NPI | 1114996402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C WALT General Manager 904-241-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL Not required) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2008-04-20 |