| NPI | 1396111258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN SMITH Owner 573-546-0241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: MO 19155212) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-11-19 |