| NPI | 1629322243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ANN SHAW Part Owner 904-557-4375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |