Healthcare Provider Details

I. General information

NPI: 1194713800
Provider Name (Legal Business Name): L & W BILLING SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91B N BROADVIEW ST
GREENBRIER AR
72058-9331
US

IV. Provider business mailing address

91B N BROADVIEW ST
GREENBRIER AR
72058-9331
US

V. Phone/Fax

Practice location:
  • Phone: 501-679-4165
  • Fax: 501-679-4403
Mailing address:
  • Phone: 501-679-4165
  • Fax: 501-679-4403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberMG00705
License Number StateAR

VIII. Authorized Official

Name: MRS. TINA MARIE LINDGREN
Title or Position: OWNER
Credential:
Phone: 501-679-4165