| NPI | 1730207192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KINSLOW Billing Assistant 270-678-2350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 2006) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-06-19 |