| NPI | 1992231799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNETTA TRAYLOR AO 502-596-6063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-06-25 |