| NPI | 1235175605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JEANNINE RUSSELL President 863-293-9747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 402) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-05-19 |