| NPI | 1912191750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DENNIS DONNELLY Owner 409-842-4821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-12-06 |