Healthcare Provider Details

I. General information

NPI: 1467463836
Provider Name (Legal Business Name): HABIBIS DURABLE MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 05/19/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4317 E BROADWAY ST
NORTH LITTLE ROCK AR
72117-4124
US

IV. Provider business mailing address

4317 E BROADWAY ST
NORTH LITTLE ROCK AR
72117-4124
US

V. Phone/Fax

Practice location:
  • Phone: 501-663-1553
  • Fax: 501-661-0738
Mailing address:
  • Phone: 501-663-1553
  • Fax: 501-661-0738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number24335360001
License Number StateAR

VIII. Authorized Official

Name: MR. ALVIN SIMMONS
Title or Position: PRESIDENT
Credential: PHARM.D.
Phone: 501-663-1553