| NPI | 1396740866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN K PPOOL President 270-365-3903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IN 60005201A) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: IN 60005201A) |
| 333600000X Pharmacy (Licence: IN 60005201A) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: IN 60005201A) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2011-08-17 |