| NPI | 1538117783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERHAN Y DESTA President 757-227-5493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 05066) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-08-22 |