| NPI | 1457425217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA COLEMAN Cbo Supervisor 501-627-1816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-12-21 |