| NPI | 1790054476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN I SCOTT Chairman 757-802-1014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-12-24 |
| Last Update Date | 2011-12-24 |