| NPI | 1952012890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEDJIE LORESTON Manager 772-204-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |