| NPI | 1225176837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE HAMPTON Member 903-785-4208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 25681) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 25681) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 25681) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TX 25681) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2024-08-12 |