| NPI | 1932862133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIANNON RUSCITTO Credentialing Specialist 757-842-7010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2021-10-15 |