| NPI | 1376620419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM HUDSON Owner 580-332-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |