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General NPI Number Information
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NPI Number | 1205475902
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Entity Type | Organization
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Legal Business Name | DAVIE MEDICAL EQUIPMENT, INC
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Dates
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Enumeration Date | 12/27/2019
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 2705 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7428
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Country | US
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Telephone | 870-425-0257
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2460
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City | MOUNTAIN HOME
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State | AR
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Zip | 72654-2460
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Country | US
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Telephone | 870-425-0257
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SOPHIA WHEELER
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Credential |
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Telephone | 870-425-0257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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