| NPI | 1013926054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIA T JACKSON Manager 318-767-8816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2010-04-27 |