| NPI | 1720264013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANN SELLS Owner 251-964-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: AL 765) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AL 765) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: AL 765) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2010-08-03 |