| NPI | 1417179680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LARRAINE TUCKER President 803-739-8987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 3897260001) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |