| NPI | 1235494634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENSON IKENNA EJINDU Owner 704-906-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 01797) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |