| NPI | 1235132671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN GRUBB President 386-752-1699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 1919) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-08-22 |