| NPI | 1366680944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA BARRACA ROGERS Owner 757-271-5909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 111394-1700) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 111394-1700) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |