| NPI | 1841372182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI SHOUP Owner 662-224-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 1415) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-05-29 |