| NPI | 1629355805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA TATE Credentialing 404-309-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |