| NPI | 1265704498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN A PARK Vice President 662-534-4445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 09198/11.1) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |