Beacon Drive Inn of Booneville,Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

013883 Issued in AR

Legal business name

BEACON DRIVE INN OF BOONEVILLE,INC

Doing business as

B.D.I.

Practice address

415 Rogers Ave
Fort Smith, AR 72901-1903

Phone

(479) 782-0363

Fax

(479) 783-1188

NPI assigned

Sep 27, 2006

Last updated

Mar 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael S Morton

Title

President

Phone

(479) 783-4672

Specialties & licenses 1

Addresses

Other names 1

• B.D.I. Doing business as

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1356432082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011903",
            "telephone_number": "479-782-0363",
            "fax_number": "479-783-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011903",
            "telephone_number": "479-782-0363",
            "fax_number": "479-783-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON DRIVE INN OF BOONEVILLE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-783-4672",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "013883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "B.D.I.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.