| NPI | 1578668265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE FARRIS PRUDHOMME President 770-907-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 4775740001) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |