| NPI | 1972126407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNCEE VASSER-CUNNINGHAM Owner/Administration 662-436-7141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-05-19 |