| NPI | 1245319409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE GRAVES Owner 501-687-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR MG00604) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: AR MG00604) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: AR MG00604) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: AR AR20396) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |