| NPI | 1518146455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA THOMPSON President 662-207-8598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| Enumeration Date | 2007-10-28 |
| Last Update Date | 2008-06-25 |