| NPI | 1760429658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS GIRARD KUNS Manager 662-690-4046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: MS 041218710) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-08-22 |