| NPI | 1548590573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY TOOLEY BOURGEOIS Administrator 251-990-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: AL 006283) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 010805) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2023-02-13 |