| NPI | 1366580557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE T MCDERMAID Owner 1810-964-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-01-22 |