Healthcare Provider Details

I. General information

NPI: 1093579898
Provider Name (Legal Business Name): MEDLINC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 JOHN ASHLEY DR
N LITTLE ROCK AR
72114-1825
US

IV. Provider business mailing address

1515 MERRILL D RIVE ST E 100
LITTLE ROCK AR
72211
US

V. Phone/Fax

Practice location:
  • Phone: 501-683-2382
  • Fax:
Mailing address:
  • Phone: 501-492-7200
  • Fax: 501-492-7211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA L ADDISON
Title or Position: DIRECTOR
Credential:
Phone: 501-492-7200