| NPI | 1770589095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A MCKINNEY Owner/President 228-475-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 00774/01.1) |
| Additional Taxonomies | 251F00000X Home Infusion (Licence: MS 00774/01.1) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: MS 00774/01.1) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MS 00774/01.1) | |
| 333600000X Pharmacy (Licence: MS 00774/01.1) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 00774011) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MS 00774011) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: MS 00774011) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2008-06-24 |