NPI | 1609865773 |
---|---|
Doing Business As | DIABETES SOURCE RX |
Entity Type | Organization |
Authorized Contact | MOLLY MOUTON Vice President 337-267-7470 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2005-10-20 |
Last Update Date | 2009-04-23 |