| NPI | 1710216080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN V ELLINGTON Admionistrator 678-391-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |