| NPI | 1407843196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY TODD TYSON President 770-449-6785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2011-09-27 |