| NPI | 1659330223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN A. DAVIS Administrator 252-492-3842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 335) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: NC 335) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-08-22 |