| NPI | 1124246814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M POULSEN Treasurer Account Manager 678-344-6889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2009-11-10 |