| NPI | 1205900958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRESTON TOLLEY President 769-233-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 251F00000X Home Infusion |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MS 06714111) | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2024-01-30 |