| NPI | 1972901379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM EVANGER President 904-517-5540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY HME00871) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2015-01-27 |