| NPI | 1962681445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SHANCEY President 904-213-0426 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1022) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2007-10-31 |