| NPI | 1710954383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT GLYNN LEEKA Prersident 662-895-1543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 03814/ 11.1) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 006675) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0871) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 0381411.1) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 018222) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 871) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2008-07-30 |