Healthcare Provider Details

I. General information

NPI: 1093854630
Provider Name (Legal Business Name): ABUNDANT CARE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3926 BASELINE RD.
LITTLE ROCK AR
72209-5408
US

IV. Provider business mailing address

3926 BASELINE RD.
LITTLE ROCK AR
72209-5408
US

V. Phone/Fax

Practice location:
  • Phone: 501-517-1092
  • Fax: 501-565-2766
Mailing address:
  • Phone: 501-517-1092
  • Fax: 501-565-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateAR

VIII. Authorized Official

Name: MRS. BERNICE L SMITH
Title or Position: OWNER MANAGER
Credential:
Phone: 501-517-1092