| NPI | 1508847179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN INGELS Billing Agent 501-663-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2011-09-02 |