=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316990708
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NPMC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2006
-----------------------------------------------------
Last Update Date | 11/05/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3604 CENTRAL AVE SUITE E
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71913-6403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-321-1402
-----------------------------------------------------
Fax | 501-321-3548
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3604 CENTRAL AVE SUITE E
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71913-6403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-321-1402
-----------------------------------------------------
Fax | 501-321-3548
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR, BUSINESS OFFICE SERVICES
-----------------------------------------------------
Name | LAURIE HOLTSFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-465-7466
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 4312
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------