1194906362 NPI number — TOTAL CARE HOME MEDICAL EQUIPMENT, LLC

Table of content: (NPI 1194906362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194906362 NPI number — TOTAL CARE HOME MEDICAL EQUIPMENT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL CARE HOME MEDICAL EQUIPMENT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194906362
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 721
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STRONG
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71765-0721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-797-7200
Provider Business Mailing Address Fax Number:
870-797-7201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9657 STRONG HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRONG
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-797-7200
Provider Business Practice Location Address Fax Number:
870-797-7201
Provider Enumeration Date:
11/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BENNETT
Authorized Official First Name:
FAYE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
870-797-7200

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 167498716 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com