MEDICARE: LIGHTYEAR WIRELESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333300000X	Emergency Response System Companies
3	343900000X	Non-emergency Medical Transport (VAN)
4	347E00000X	Transportation Broker
5	385H00000X	Respite Care
6	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1831872662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTYEAR WIRELESS

Provider Business Mailing Address
First Line	:	6834 CANTRELL RD # 2099
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72207-4135
Country	:	US
Telephone Number	:
Fax Number	:	501-333-9192

Provider Business Practice Location Address
First Line	:	4700 W COMMERCIAL DR STE B3
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-8073
Country	:	US
Telephone Number	:	501-557-3888
Fax Number	:	501-333-9192

Authorized Official
Title or Position	:	CLIENT CARE MANAGER
Name	:	LATOSHA MARTIN
Credential	:
Telephone Number	:	501-557-3888

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	08/09/2023

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Directions to “LIGHTYEAR WIRELESS ” Practice Location

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