| NPI | 1922023860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA T. REED CEO 662-247-1254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 04739/11.1) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MS 04739/11.1) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: MS 04739/11.1) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MS 04739/11.1) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-07-11 |