| NPI | 1720055908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R BROCKWAY President 901-323-1304 |
| Organization Subpart ? | |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000001104) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 04203 / 11.1) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR MG01258) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2012-03-07 |