| NPI | 1790672632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK MARTIN Authorized Official 678-941-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-07-01 |