| NPI | 1679582241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA T BLACK Owner 843-266-1304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 249043615) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |