| NPI | 1003629767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KENT Credentialing Director 501-900-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-01-28 |
| Last Update Date | 2025-01-28 |