| NPI | 1588824304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSIE M WHITE President 757-848-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 110704) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 110704) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |