| NPI | 1700034162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANGELA HARRIS Owner 601-846-0169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-10-01 |