| NPI | 1659921823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDIA B OWENS Co Owner 704-408-6950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2025-01-15 |