| NPI | 1124133558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA STALLWORTH President 703-768-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 0622765) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2025-02-14 |