| NPI | 1073696035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE JOHNSON Owner 601-446-8907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 8313151) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-04-14 |