| NPI | 1629319041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA BANKHEAD Director 469-531-2507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: 1001071) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2013-03-11 |