| NPI | 1962549709 |
|---|---|
| Doing Business As | SUPER D EXPRESS RX #8407 |
| Entity Type | Organization |
| Authorized Contact | GARY BOONE Director Of Hme Operations 479-394-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2010-01-09 |