MEDICARE: ACCESSIBILITY SPECIALTIES INC

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	225CA2500X	Assistive Technology Supplier Rehabilitation Counselor		AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49936	OTHER	AR	AR BLUE CROSS BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184635963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESSIBILITY SPECIALTIES INC

Provider Business Mailing Address
First Line	:	PO BOX 45875
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72214-5875
Country	:	US
Telephone Number	:	501-312-1000
Fax Number	:	501-312-1100

Provider Business Practice Location Address
First Line	:	1920 JOHN BARROW RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-1448
Country	:	US
Telephone Number	:	501-312-1000
Fax Number	:	501-312-1100

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RUSSELL ALAN MASHBURN
Credential	:
Telephone Number	:	501-312-1000

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	03/12/2009

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