| NPI | 1891119707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER D WHIDDON President 386-754-7367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL CRC1328025) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-12 |