| NPI | 1538430616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALEB M UMSTEAD Manager 386-623-0397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2012-01-20 |