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General NPI Number Information
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NPI Number | 1144007162
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Entity Type | Organization
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Legal Business Name | PALCO CHOICE, INC
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 501 MILLWOOD CIR STE A
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City | MAUMELLE
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State | AR
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Zip | 72113-6304
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Country | US
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Telephone | 501-604-9936
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13260
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City | MAUMELLE
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State | AR
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Zip | 72113-0260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | VICKI DENNISON
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Credential |
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Telephone | 501-604-9936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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