Healthcare Provider Details

I. General information

NPI: 1740361500
Provider Name (Legal Business Name): C A KUYKENDALL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 05/24/2025
Certification Date: 05/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W COMMERCIAL ST
OZARK AR
72949-3112
US

IV. Provider business mailing address

500 W COMMERCIAL ST
OZARK AR
72949-3112
US

V. Phone/Fax

Practice location:
  • Phone: 479-667-2101
  • Fax: 479-667-1270
Mailing address:
  • Phone: 479-667-2101
  • Fax: 479-667-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAR12813
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberAR12813
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberAR12813
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR12813
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberAR12813
License Number StateAR
# 6
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberAR12813
License Number StateAR
# 7
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberAR12813
License Number StateAR

VIII. Authorized Official

Name: DR. CHESTER ARTHUR KUYKENDALL JR.
Title or Position: PRESIDENT
Credential: P.D.
Phone: 479-667-2101