| NPI | 1912032020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY W POLLEY Executive Director 314-714-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2010-09-08 |