Healthcare Provider Details

I. General information

NPI: 1245590066
Provider Name (Legal Business Name): APH&R NURSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2012
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 CUMBERLAND ST
LITTLE ROCK AR
72202-5065
US

IV. Provider business mailing address

1516 CUMBERLAND ST
LITTLE ROCK AR
72202-5065
US

V. Phone/Fax

Practice location:
  • Phone: 501-374-7565
  • Fax: 501-372-8026
Mailing address:
  • Phone: 501-374-7565
  • Fax: 501-372-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BOYD P GENTRY
Title or Position: PRESIDENT & CEO
Credential:
Phone: 678-869-5118