NPI | 1144574138 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS CARROLL FARRAR Owner/Operator/Dispenser 601-602-4147 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MS HA0502) |
Enumeration Date | 2012-10-30 |
Last Update Date | 2017-05-01 |