| NPI | 1912134248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE DENISE ETHEREDGE Diabetic Consultant 803-520-8117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2009-06-12 |