| NPI | 1588011613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CLAYTON MCPETERS Manager 239-215-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 12345) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |