| NPI | 1790903268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH E SELBY Owner Officer 800-768-0336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 591) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 3300368) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-12-12 |