| NPI | 1649965963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM MIXON Owner 251-947-5593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 333600000X Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-02-23 |