| NPI | 1942052816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTAE T COOPER Specialist 912-233-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-04-03 |