| NPI | 1154400323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JEROLD STOUT President 423-336-1651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-05-21 |