| NPI | 1902829500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MITCHELL Owner 864-296-6911 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 004294301) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: SC 004294301) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: SC 004294301) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-06-20 |