| NPI | 1902227697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY PEDEN Manager 270-467-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07503) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: KY P07503) |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: KY P07503) | |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |