| NPI | 1215195045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE ROBERTSON WAMBLE C Ph T Manager 662-236-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 13861go) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-06-18 |