| NPI | 1255357539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY SULLIVAN President 228-897-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 8714) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-08-12 |