| NPI | 1548395221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIOLA DARR Owner 870-932-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: AR AR20511) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-10-25 |