Healthcare Provider Details

I. General information

NPI: 1356510309
Provider Name (Legal Business Name): LIMA NEUROCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 SE 28TH ST STE 5
BENTONVILLE AR
72712-4294
US

IV. Provider business mailing address

811 SE 28TH ST STE 5
BENTONVILLE AR
72712-4294
US

V. Phone/Fax

Practice location:
  • Phone: 479-254-9761
  • Fax: 479-254-9732
Mailing address:
  • Phone: 479-254-9761
  • Fax: 479-254-9732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number35078468
License Number StateOH

VIII. Authorized Official

Name: AHMAD AL-KHATIB
Title or Position: PRESIDENT
Credential: M.D.
Phone: 479-254-9761