| NPI | 1861565855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DICKENS Billing Manager 757-594-3944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2009-03-25 |