| NPI | 1790059806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BURTON President 662-269-2973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MS 10819-11.1) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-10-08 |