MEDICARE: CONTOURMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1053663062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTOURMED

Provider Business Mailing Address
First Line	:	2217 COTTONDALE LN
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-2018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 COTTONDALE LN
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-2018
Country	:	US
Telephone Number	:	501-907-0530
Fax Number	:	502-907-0533

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BARRY CORKERN
Credential	:
Telephone Number	:	501-664-7866

Provider Enumeration Date	:	10/15/2012
Last Update Date	:	10/15/2012

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Directions to “CONTOURMED ” Practice Location

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