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General NPI Number Information
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NPI Number | 1154680544
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Entity Type | Organization
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Legal Business Name | LITTLE ROCK RESPIRATORY
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 15001 CHICOPEE TRL
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City | LITTLE ROCK
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State | AR
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Zip | 72210-3232
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Country | US
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Telephone | 501-838-6921
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Fax |
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Provider Business Mailing Address
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Address Line | 15001 CHICOPEE TRL
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City | LITTLE ROCK
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State | AR
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Zip | 72210-3232
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Country | US
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Telephone | 501-838-6921
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. TIMOTHY OWEN JOHNSON
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Credential |
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Telephone | 501-658-9491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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