| NPI | 1124264114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA V HENDERSON Proprietor 866-365-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PO1685) |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2008-12-23 |