MEDICARE: ARKANSAS HOME MEDICAL

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	MG00777	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316047194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKANSAS HOME MEDICAL

Provider Business Mailing Address
First Line	:	PO BOX 367
Second Line	:
City	:	MARSHALL
State	:	AR
Zip	:	72650-0367
Country	:	US
Telephone Number	:	870-448-5984
Fax Number	:	870-448-3697

Provider Business Practice Location Address
First Line	:	3531 CENTRAL AVENUE
Second Line	:	SUITE E
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6280
Country	:	US
Telephone Number	:	501-620-4553
Fax Number	:	501-620-4541

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	SHERRI A MASSEY
Credential	:
Telephone Number	:	870-448-5984

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/10/2010

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Directions to “ARKANSAS HOME MEDICAL ” Practice Location

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