| NPI | 1871759118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BLACK President 772-398-2122 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2016-07-29 |