| NPI | 1629065560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE EDNEY Owner 580-243-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2019-10-18 |