| NPI | 1629167663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST L. WAIDE President 270-824-9227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 001533) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-05-13 |