| NPI | 1518962760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SUE CLARK Director 479-709-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |