| NPI | 1639363096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY K. BOWLING Accountant 256-117-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: AL 171) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 171) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |