| NPI | 1487094256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM I MADDOX CFO 723-756-2268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2014-10-07 |