| NPI | 1326244120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY VICK VP Finance 229-924-9352 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2009-03-12 |