| NPI | 1215190673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SETH BLACK President 772-398-2122 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1001500) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2018-03-23 |