| NPI | 1477755965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH W. BOULDEN Owner 302-376-6721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DE 2007217822) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-08-22 |