Healthcare Provider Details

I. General information

NPI: 1245005305
Provider Name (Legal Business Name): ADVANCED RESPIRATORY SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 10/19/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 W WADE AVE STE 2
MOUNTAIN HOME AR
72653-4623
US

IV. Provider business mailing address

1428 THISTLEDOWN
MOUNTAIN HOME AR
72653-5255
US

V. Phone/Fax

Practice location:
  • Phone: 501-766-0859
  • Fax:
Mailing address:
  • Phone: 870-706-2601
  • Fax: 870-706-2608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SARAH KNIGHT
Title or Position: OWNER
Credential:
Phone: 870-706-2601