| NPI | 1740559988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JACKSON President 606-638-3234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |