| NPI | 1912975749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DOUGLAS BLAKE Owner 870-733-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: AR mg00601) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-03-28 |