NPI | 1821423229 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY MATUKEWICZ Secretary 423-756-2268 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 171W00000X Contractor |
171WH0202X Contractor Home Modifications | |
171WV0202X Contractor Vehicle Modifications | |
332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
Enumeration Date | 2013-09-05 |
Last Update Date | 2020-04-03 |