| NPI | 1710308408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS HUDNALL Owner 270-651-5159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07492) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY P07492) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: KY P07492) | |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |