| NPI | 1629021225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM R DAUGHERTY Member 423-789-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: VA 0206009338) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-08-06 |