| NPI | 1851936041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI WHITESIDE Director Regulatory Licensing 770-248-8740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2021-03-05 |