| NPI | 1629015128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA FENDER Office Manager 229-244-5261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2009-11-13 |