| NPI | 1780013706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TRUITT Manager 267-760-1850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA 6000008234) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2016-03-01 |