| NPI | 1235533662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY P CARSON Managing Member 662-257-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 13643/11.1) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2021-11-12 |