| NPI | 1518976380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CREEL Office Manager 601-919-9196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: MS 04553/11.1) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2019-02-13 |