| NPI | 1396805438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROD PENCEK Owner 615-220-5609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000002171) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TN 0000002171) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2011-08-26 |