| NPI | 1720001084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK COFFETT President 314-966-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 15710874) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-12-18 |