| NPI | 1518086339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERRI SANDERSON Owner 662-597-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 08376/02.0) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2013-08-28 |