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General NPI Number Information
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NPI Number | 1902886104
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Entity Type | Organization
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Legal Business Name | CAMDEN MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 5322 BLEAUX AVE SUITE C
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City | SPRINGDALE
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State | AR
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Zip | 72762-0731
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Country | US
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Telephone | 479-872-1488
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Fax | 479-751-6630
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Provider Business Mailing Address
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Address Line | PO BOX 27968
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0968
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Country | US
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Telephone | 407-246-1226
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Fax | 407-648-2297
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. ROBIN L MENCHEN
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Credential |
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Telephone | 407-822-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #5
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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 |
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