| NPI | 1154339828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS A WARNER Owner 843-661-2166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 021307578) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-11-14 |