| NPI | 1609919265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD L. PONQUINETTE President 251-471-2113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 118) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-05-22 |