| NPI | 1659719631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTANA LAVON NOTTAGE President/CEO 443-315-5945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MD 03695969) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MD 03695969) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-07-01 |