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General NPI Number Information
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NPI Number | 1629384664
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Entity Type | Organization
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Legal Business Name | MEDIQUEST INC
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1204 SE 28TH ST SUITE 12
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City | BENTONVILLE
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State | AR
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Zip | 72712-3881
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Country | US
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Telephone | 479-464-8833
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Fax | 479-750-7462
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Provider Business Mailing Address
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Address Line | 1204 SE 28TH ST SUITE 12
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City | BENTONVILLE
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State | AR
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Zip | 72712-3881
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Country | US
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Telephone | 479-464-8833
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Fax | 479-750-7462
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Authorized Official
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Title or Position | MEDICAL IT ADMINISTRATOR
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Name | MR. MAILAN OLIQUINO PINEDA
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Credential |
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Telephone | 479-750-7463
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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 | AR
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