| NPI | 1417510561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA CHAUNCEY Payer Relations Manager 423-756-2268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 171WV0202X Contractor, Vehicle Modifications | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2020-09-17 |