| NPI | 1194756296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE C PRUETT President/C.O.B. 254-772-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: TX 0034661) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0034661) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-22 |