| NPI | 1639149727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN CANNAN Director 803-227-4468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2013-04-26 |