| NPI | 1932570454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYSHANDRA N HARALSON Special Projects Manager 601-354-7866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 1064195) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2019-08-23 |