| NPI | 1912942640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD RANDY ROGERS Owner 318-218-9583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |