Healthcare Provider Details

I. General information

NPI: 1407838717
Provider Name (Legal Business Name): ASSIST MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MORGAN KEEGAN DR SUITE 120
LITTLE ROCK AR
72202-2286
US

IV. Provider business mailing address

PO BOX 1033
LITTLE ROCK AR
72203-1033
US

V. Phone/Fax

Practice location:
  • Phone: 501-666-4800
  • Fax:
Mailing address:
  • Phone: 501-376-1975
  • Fax: 501-666-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. PEGGY LYNN MOODY
Title or Position: MANAGER
Credential:
Phone: 501-376-1975