| NPI | 1831153170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORBERTA M MONTES Owner 843-669-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 053294) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: SC 053294) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: SC 053294) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-08-22 |