| NPI | 1164108825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER J MITCHELL CEO 972-380-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-07-06 |