| NPI | 1982787461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYNN S SANDERS Owner 662-378-1874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 1568PG) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2009-05-29 |