| NPI | 1720207848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH FIELDS DE HERDER Owner 843-766-6494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: SC 010720240) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 010720240) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2008-02-01 |