NPIMap

Organization Active NPI

Extendi-Care, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Conway, AR
National Provider Identifier
1316933658
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
005155 Issued in AR
Legal business name
EXTENDI-CARE, INC.
Practice address
824 Salem Rd
Ste. 240
Conway, AR 72034-4821
Phone
(501) 548-0190
Fax
(501) 327-5533
NPI assigned
Sep 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
A Brandon Adams
Title
President
Phone
(501) 548-0190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 005155 AR Primary

Addresses

Primary practice location

824 Salem Rd
Ste. 240
Conway, AR 72034-4821

Mailing address

824 Salem Rd
Ste. 240
Conway, AR 72034-4821
Phone (501) 548-0190

Other names 1

  • Lakeside DME Doing business as

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

824 Salem Rd
Ste 240
Conway, AR 72034
Phone (501) 548-0190

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1316933658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 SALEM RD",
            "address_2": "STE. 240",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344821",
            "telephone_number": "501-548-0190",
            "fax_number": "501-327-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 SALEM RD",
            "address_2": "STE. 240",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344821",
            "telephone_number": "501-548-0190",
            "fax_number": "501-327-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDI-CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "A",
        "authorized_official_middle_name": "BRANDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-548-0190"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "005155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.