Healthcare Provider Details
I. General information
NPI: 1366190084
Provider Name (Legal Business Name): LITTLE ROCK INFUSION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/11/2022
Last Update Date: 07/10/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15200 CHENAL PKWY STE 100
LITTLE ROCK AR
72211
US
IV. Provider business mailing address
15200 CHENAL PKWY STE 100
LITTLE ROCK AR
72211
US
V. Phone/Fax
- Phone: 501-451-6080
- Fax: 501-451-6081
- Phone: 501-451-6080
- Fax: 501-451-6081
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLAIM
A.
HEGI
Title or Position: OWNER
Credential:
Phone: 601-594-6237