| NPI | 1265764088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT THOMAS BALDRIDGE Owner 800-306-5160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 1014) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TN 1014) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2021-10-08 |