Healthcare Provider Details

I. General information

NPI: 1245319409
Provider Name (Legal Business Name): I CARE OF ARKANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 S BOWMAN RD SUITE D
LITTLE ROCK AR
72211-4207
US

IV. Provider business mailing address

1527 S BOWMAN RD SUITE D
LITTLE ROCK AR
72211-4207
US

V. Phone/Fax

Practice location:
  • Phone: 501-687-0999
  • Fax: 501-687-0879
Mailing address:
  • Phone: 501-687-0999
  • Fax: 501-687-0879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberMG00604
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberMG00604
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberMG00604
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberAR20396
License Number StateAR

VIII. Authorized Official

Name: MR. GENE GRAVES
Title or Position: OWNER
Credential: PHARND
Phone: 501-687-0999