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General NPI Number Information
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NPI Number | 1407170897
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Entity Type | Organization
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Legal Business Name | ANAYA MEDICAL, INC
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 610 N FLENNIKEN AVE
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City | EL DORADO
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State | AR
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Zip | 71730-4523
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Country | US
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Telephone | 870-875-2200
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Fax | 870-875-2203
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Provider Business Mailing Address
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Address Line | PO BOX 10505
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City | EL DORADO
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State | AR
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Zip | 71730-0003
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Country | US
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Telephone | 870-875-2200
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Fax | 870-875-2203
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LORNA ANAYA
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Credential | BSC,LGAT,CFTS
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Telephone | 870-875-2200
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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 | MG01021
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License Number State | AR
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