| NPI | 1972984813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY DAVENPORT Operations Manager 706-612-9856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA ga4569) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |