| NPI | 1477027241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN GENTRY Owner/Manager 863-414-3256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |