| NPI | 1194808675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY SMITH Owner 662-332-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 892PSG) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |