| NPI | 1780756148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA FORTNER CEO 423-648-2095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TN 0000000879) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |