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General NPI Number Information
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NPI Number | 1215018387
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Entity Type | Organization
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Legal Business Name | COMPLETE HOME CARE SUPPLY INC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 5309 MCCLANAHAN DR STE F4
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7075
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Country | US
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Telephone | 800-280-2050
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Fax | 501-753-1635
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Provider Business Mailing Address
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Address Line | 5309 MCCLANAHAN DRIVE, STE. F-4
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116
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Country | US
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Telephone | 800-280-2050
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Fax | 501-753-1635
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JERAL DEAN HOWARD
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Credential |
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Telephone | 800-280-2050
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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 | 0000001546
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License Number State | AR
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