| NPI | 1588034862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARRON LORRAINE TAYLOR-HAGGETT Owner 757-570-3932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA S5754090) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA S5754090) |
| 171WH0202X Contractor, Home Modifications (Licence: VA S5754090) | |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |