| NPI | 1356007785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JACKSON Billing Specialist 304-225-6290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2024-11-15 |