| NPI | 1891021523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN HOLLOWAY CEO/Manger 704-999-0943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 10-0167296) |
| Additional Taxonomies | 251X00000X (Licence: NC 10-0167296) |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies (Licence: NC 10-0167296) | |
| 347E00000X Transportation Broker (Licence: NC 10-0167296) | |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2009-10-30 |