| NPI | 1154953123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA FROMKIN Credentialing Mgr 706-494-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2023-08-18 |