PTCOA HOME INFUSION SERVICES LLC NPI 1235723313

NPI Information

NPI: 1235723313
Provider Name: PTCOA HOME INFUSION SERVICES LLC
Classification: Home Infusion - 251F00000X
Entity Type: Organization

CLIA Number: 04D2272918

Address:
108 N SHACKLEFORD RD
LITTLE ROCK, AR
ZIP 72211
Phone: (844) 215-0731
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PTCOA HOME INFUSION SERVICES LLC is a home infusion in Little Rock, AR. PTCOA HOME INFUSION SERVICES LLC NPI is 1235723313. The provider is registered as an organization entity type.

The provider's business location address is:

108 N SHACKLEFORD RD
LITTLE ROCK, AR
ZIP 72211-840
Phone: (844) 215-0731
Fax: (501) 404-7789

The provider's authorized official is Meraj Siddiqui .
The authorized official title is Owner and has the following contact phone number (501) 712-2571.

The CLIA number assigned to this NPI record is 04D2272918 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2021 and was last updated on 3/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251F00000X	Home Infusion				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MG01994	OTHER	ARKANSAS	SUPPLIER MEDICAL EQUIPMENT LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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