| NPI | 1053368076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE RUSSELL HUBBS President/Owner 606-528-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY MG0109) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: KY MG0109) | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2018-09-10 |