| NPI | 1629507579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA ANNE BERG Owner/CFO 904-629-3197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1313693) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2021-01-14 |