PEDS PLUS ORTHOTICS LLC NPI 1447632690

NPI Information

NPI: 1447632690
Provider Name: PEDS PLUS ORTHOTICS, LLC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
3851 HARRISON RD
BENTON, AR
ZIP 72019
Phone: (501) 607-0144
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PEDS PLUS ORTHOTICS, LLC is a customized equipment durable medical equipment medical supplies in Benton, AR. PEDS PLUS ORTHOTICS, LLC NPI is 1447632690. The provider is registered as an organization entity type.

The provider's business location address is:

3851 HARRISON RD
BENTON, AR
ZIP 72019-632
Phone: (501) 607-0144
Fax: (501) 794-1021

The provider's authorized official is Bryan Keith Flynn .
The authorized official title is Owner and has the following contact phone number (501) 607-0144.

The enumeration date for this NPI number is 6/24/2015 and was last updated on 6/24/2015.

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	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			Yes

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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