| NPI | 1417904814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSCELL D PAVLIN 3 M Director 417-380-5105 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-08-24 |