| NPI | 1467783662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY STIDHAM Owner 901-596-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-01-28 |