| NPI | 1861898975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL E COMBS Credentialing Coordinator 615-503-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2015-11-10 |