| NPI | 1528295581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN SUDDUTH Manager 601-479-4963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2022-07-21 |