| NPI | 1285067579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMRIE L WELLS Director 479-394-8055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2013-09-11 |