Healthcare Provider Details

I. General information

NPI: 1114846722
Provider Name (Legal Business Name): FOR GOD'S GLORY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3170 E KIEHL AVE
SHERWOOD AR
72120-4378
US

IV. Provider business mailing address

3170 E KIEHL AVE
SHERWOOD AR
72120-4378
US

V. Phone/Fax

Practice location:
  • Phone: 501-416-0187
  • Fax:
Mailing address:
  • Phone: 501-416-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LYNN DANETTE WALLS
Title or Position: RN/ADM
Credential: RN
Phone: 501-416-0187