| NPI | 1972796670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD BRADSHAW Owner 843-266-0027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies |
| Enumeration Date | 2007-08-25 |
| Last Update Date | 2007-10-16 |