Diabetic Resources of Arkansas, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

MG00510 Issued in AR

Legal business name

DIABETIC RESOURCES OF ARKANSAS, LLC

Practice address

911 E Parker Rd
Jonesboro, AR 72404-8370

Phone

(870) 935-6700

Fax

(870) 935-6700

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Harrison White

Title

Member/Owner

Phone

(870) 935-6700

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1558453894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 444",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72403",
            "telephone_number": "870-935-6700",
            "fax_number": "870-935-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E PARKER RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048370",
            "telephone_number": "870-935-6700",
            "fax_number": "870-935-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC RESOURCES OF ARKANSAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HARRISON",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "870-935-6700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "MG00510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149490716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "49853",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Chaarles Devasier, MHPP
• Rita Devine
• Dinah M Dexter, LMSW
• Roger Dexter
• Amirtharaj Dhanaraja, M.D.
• Corey Lynn Diamond, MD
• Elmo Diaz Velazquez, M.D.
• Pamela Denice Diaz, LCSW
• Tatianna Nicole Diaz
• Abby Dickey

• Durable Medical Equipment & Medical Supplies in Jonesboro, AR
• Providers in Jonesboro, 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 9, 2009; 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.