| NPI | 1770541435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON D PENDERGRAS President 915-581-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 33bp3500x) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-04-17 |