| NPI | 1235296682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY JOHNSON Exec VP 936-634-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: TX 25265) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |