| NPI | 1922753490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANDRA RAYSHON GIBBS Owner 601-513-4956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-02-14 |