| NPI | 1164654539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK WALLACE CEO 409-835-3091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2010-03-25 |