| NPI | 1790937589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE O LONGMORE Managing Partner 757-409-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 2705096060) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2008-10-13 |