| NPI | 1780127001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DRUSILLA M FULTON Provider 704-293-5718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 12120) |
| Enumeration Date | 2016-11-19 |
| Last Update Date | 2016-11-19 |