| NPI | 1841488269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELICIA ENISHA JORDAN ROSS Owner 843-662-1407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2007-10-10 |