| NPI | 1245415363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL JOHNSON Administrator 704-637-3784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: NC NH0197) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |