| NPI | 1558553297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA G STOUDENMIRE Owner 251-460-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 763) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: AL 1256) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: AL 9000644) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-16 |