| NPI | 1710502067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS RAY BLOCKER Owner 210-514-6252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2022-04-27 |