Healthcare Provider Details

I. General information

NPI: 1134145964
Provider Name (Legal Business Name): ADVANCED HOME IV SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 STURGIS RD STE 7
CONWAY AR
72034-9688
US

IV. Provider business mailing address

1235 STURGIS RD STE 7
CONWAY AR
72034-9688
US

V. Phone/Fax

Practice location:
  • Phone: 501-336-8350
  • Fax: 501-336-8571
Mailing address:
  • Phone: 501-336-8350
  • Fax: 501-336-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberAR20276
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberAR20276
License Number StateAR

VIII. Authorized Official

Name: MRS. ANGELA MARIE TAPLEY
Title or Position: OWNER/PHARMACIST
Credential: PHARM D.
Phone: 501-336-8350