| NPI | 1437157013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY EARL WAGNER President/CEO 772-205-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1312539) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2008-12-02 |