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NPI Code Detail

MEDICARE: SPARKS MEDICAL FOUNDATION

MEDICARE: SPARKS MEDICAL FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesAR

General Provider Information

NPI Number : 1043310451
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPARKS MEDICAL FOUNDATION
Provider Business Mailing Address
First Line : PO BOX 2420
Second Line :
City : FORT SMITH
State : AR
Zip : 72902-2420
Country : US
Telephone Number : 479-709-7399
Fax Number : 479-709-7053
Provider Business Practice Location Address
First Line : 8600 S 36TH TER
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-8768
Country : US
Telephone Number : 479-709-7473
Fax Number : 479-709-7466
Authorized Official
Title or Position : CBO SUPPORT MANAGER
Name : REBECCA COX
Credential :
Telephone Number : 479-709-7057
Provider Enumeration Date : 09/25/2006
Last Update Date : 05/01/2008

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Directions to “SPARKS MEDICAL FOUNDATION ” Practice Location

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