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General NPI Number Information
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NPI Number | 1659508828
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Entity Type | Organization
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Legal Business Name | PDB ENTERPRISES, INC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 10402 STAGECOACH ROAD SUITE G
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City | LLITTLE ROCK
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State | AR
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Zip | 72210-8986
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Country | US
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Telephone | 501-455-0950
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Fax | 501-455-4065
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Provider Business Mailing Address
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Address Line | PO BOX 30220
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City | LITTLE ROCK
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State | AR
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Zip | 72260-0005
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Country | US
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Telephone | 501-455-0950
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Fax | 501-455-4065
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Authorized Official
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Title or Position | CEO
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Name | MS. PATRICIA DODSON BROWN
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Credential | RN, CCM, CLCP
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Telephone | 501-455-0950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | BL00034171
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License Number State | AR
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