| NPI | 1942290192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KATHLEEN RENFRO VP Operations 972-899-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0071456) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-08-22 |