| NPI | 1790094530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA GALE BREWER Owner/Operator 270-554-7242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2010-09-28 |