| NPI | 1568871572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY VARNER Administrator 662-473-1411 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |