| NPI | 1023087855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERMIKA SMITH Billing Manager 601-638-4076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-07-21 |