| NPI | 1255320123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY ANN SMITH Credentialing Specialist 318-798-4539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-08-22 |