| NPI | 1609944024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRI K. SLEEM Director 910-485-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: NC 01069) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 01069) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: NC 01069) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-01-18 |