PKC Medical Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PKC MEDICAL SUPPLIES

Practice address

915 W B St
Russellville, AR 72801-3501

Phone

(479) 968-1777

Fax

(479) 967-1111

NPI assigned

Sep 28, 2023

Last updated

Sep 28, 2023By 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

Lana Carruth, RN

Title

Owner

Phone

(479) 968-1777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phylana K Carruth, RN

  • General Practice Registered Nurse
  • Russellville, AR
  • NPI 1760156954

  Durable Medical Equipment & Medical Supplies

  NPD

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1366221293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W B ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013501",
            "telephone_number": "479-968-1777",
            "fax_number": "479-967-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W B ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013501",
            "telephone_number": "479-968-1777",
            "fax_number": "479-967-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PKC MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "CARRUTH",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-968-1777",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neylon Pilkington, MD
• Pinnacle in Home Care, LLC (Pinnacle In Home Care Russellville)
• Amy Melissa Pintado, PA-C
• Katie Pipkin, M.S., CF-SLP
• Addy Pitts, M.H.P.P
• Points of Light Counseling Services, Inc.
• Allie Grace Pollock
• Pope County (Pope County Emergency Medical Services)
• Pope County Imaging
• Pope Emergency Group LLC

• Durable Medical Equipment & Medical Supplies in Russellville, AR
• Providers in Russellville, 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 Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.