| NPI | 1902982184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE I BUTLER President 386-792-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1175) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2009-11-19 |