| NPI | 1508981655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA CARBAJAL MASHTARE Administrator 757-672-4288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |