| NPI | 1790439099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LARRY WATERS CEO 770-490-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |