| NPI | 1821862335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY STARR PRESCOTT Owner/Provider 904-846-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |