| NPI | 1689629149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MICHELE ROSE Managing Member 479-636-5716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: AR 332BP3500X) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |