| NPI | 1508828955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY D. SHANER Billing Specialist 910-892-9286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: NC 01501 (BDP)) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: NC 13310) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2022-06-27 |