| NPI | 1134269384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH L STACEY Owner Administrator 859-292-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |