| NPI | 1982967709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN L STAUFFER Operations Manager 912-285-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2015-11-02 |