| NPI | 1710679543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES L. HICKS, III Manager 601-642-6023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-05-22 |