| NPI | 1497931273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA VANDEVANDER Credentialing Manager 540-213-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 0101840518) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2025-08-19 |