| NPI | 1255364295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS K MITTLEIDER President 770-619-0866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2008-08-14 |