| NPI | 1548661135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISTAN JOSEPH HOGAN Program Director 903-917-1115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |