Healthcare Provider Details

I. General information

NPI: 1679576557
Provider Name (Legal Business Name): TRI-COUNTY MEDICAL SUPPLY & RESPIRATORY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 04/25/2022
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 HIGHWAY 62 E
SALEM AR
72576-9545
US

IV. Provider business mailing address

PO BOX 760
SALEM AR
72576-0760
US

V. Phone/Fax

Practice location:
  • Phone: 870-895-5022
  • Fax: 870-895-4759
Mailing address:
  • Phone: 870-895-5022
  • Fax: 870-895-4759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MAX A CALDWELL
Title or Position: PRESIDENT
Credential:
Phone: 870-238-7085