| NPI | 1003035759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELLA DARLENE PUGH Owner/Operator 618-285-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203000770) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-03-24 |