| NPI | 1184830911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC ROSS Manager 757-595-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 4651840001) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 4651840001) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |