| NPI | 1740539790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE KALBAUGH Credentialing Specialist 336-878-8824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2017-08-23 |