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EXTENDI-CARE INC. NPI 1316933658


NPI Information

NPI: 1316933658
Provider Name: EXTENDI-CARE, INC.

Doing Business As: LAKESIDE DME

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
824 SALEM RD
STE. 240
CONWAY, AR
ZIP 72034
Phone: (501) 548-0190
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EXTENDI-CARE, INC. is a durable medical equipment medical supplies in Conway, 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. EXTENDI-CARE, INC. NPI is 1316933658. The provider is registered as an organization entity type.
The provider Is Doing Business As Lakeside Dme.

The provider's business location address is:

824 SALEM RD
STE. 240
CONWAY, AR
ZIP 72034-821
Phone: (501) 548-0190
Fax: (501) 327-5533

The provider's authorized official is A Brandon Adams .
The authorized official title is President and has the following contact phone number (501) 548-0190.

The enumeration date for this NPI number is 9/22/2005 and was last updated on 12/3/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies005155ARKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10983000002MEDICARE NSCARKANSAS

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: 11/14/2023

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