| NPI | 1528957248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHENIQUE THADREKA BROWN Authorized Official 346-301-9857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-10-22 |