| NPI | 1649844804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA HANKERSON Manager 545-999-5379 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |