| NPI | 1124213855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA PUATHASNANON Chief Counsel 804-550-2017 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 611) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2018-01-09 |