| NPI | 1659553030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK RAYMOND President 904-378-1941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |