| NPI | 1528823671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONDA D HARRIS Owner 463-210-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332U00000X Home Delivered Meals |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| 347C00000X Private Vehicle | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |