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General NPI Number Information
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NPI Number | 1346460664
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Entity Type | Organization
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Legal Business Name | FORREST CITY HOME MEDICAL EQUIPMENT, LLC
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 101 N ROSSER ST
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City | FORREST CITY
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State | AR
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Zip | 72335-3219
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Country | US
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Telephone | 870-633-5176
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Fax | 870-630-0530
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Provider Business Mailing Address
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Address Line | PO BOX 106
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City | FORREST CITY
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State | AR
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Zip | 72336-0106
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Country | US
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Telephone | 870-633-5176
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Fax | 870-630-0530
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Authorized Official
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Title or Position | BILLING
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Name | MRS. LISA A PRUIETT
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Credential |
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Telephone | 870-633-5176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AR4360
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License Number State | AR
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