NPI | 1629248190 |
---|---|
Former Legal Business Name | LILLIAN CONVENIENT CARE |
Entity Type | Organization |
Authorized Contact | RADCLIFFE J COYLE Dr. / Owner 251-962-4362 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: AL 6346) |
Enumeration Date | 2008-03-11 |
Last Update Date | 2008-04-08 |