| NPI | 1780681452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN WAYNE POGUE CEO 334-270-1342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-08-22 |