| NPI | 1053716712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORA PEGUES Administrator 662-843-3785 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |