| NPI | 1083157804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEKIA RENIX JACKSON CEO 662-563-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 15048/11.1) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |