| NPI | 1295738912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD O. KING Owner 662-665-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MS 05685/11.1) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MS 05774/02.0) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2020-08-22 |