| NPI | 1568390144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS SIMMONS Director 985-999-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2026-05-12 |
| Last Update Date | 2026-06-30 |