| NPI | 1821010828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY JEWELL GREMILLION Owner 2256-638-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-10-30 |