| NPI | 1346266632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY D LONG Billing Mgr 386-698-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 1022) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2009-01-05 |