| NPI | 1033536453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WILCOX Owner 870-534-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN Applied for) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2025-09-15 |