PEDIATRIC NUTRITION PROVIDER OF ARKANSAS NPI 1265569453

NPI Information

PEDIATRIC NUTRITION PROVIDER OF ARKANSAS is a durable medical equipment medical supplies in Benton, AR. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. PEDIATRIC NUTRITION PROVIDER OF ARKANSAS NPI is 1265569453. The provider is registered as an organization entity type.
The provider Is Doing Business As Arkansas Respiratory & Equipment Provider.

The provider's business location address is:

920 EDISON AVE
SUITE 8
BENTON, AR
ZIP 72015-502
Phone: (501) 315-7337

The provider's authorized official is Nicole C Motto .
The authorized official title is Co-owner and has the following contact phone number (501) 315-7337.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 8/22/2020.

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:

Other Identifiers

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

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