| NPI | 1770210122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA THEDFORD Authorized Offical 601-513-4956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2023-04-05 |