Malcbndr581, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MALCBNDR581, LLC

Practice address

6411 Valley Ranch Dr
Little Rock, AR 72223

Phone

(601) 853-2667

Fax

(601) 853-2116

NPI assigned

Oct 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. David Rotolo

Title

Member

Phone

(601) 853-2667

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Valley Ranch Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1558697227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3376",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391583376",
            "telephone_number": "601-853-2667",
            "fax_number": "601-853-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 VALLEY RANCH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "601-853-2667",
            "fax_number": "601-853-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALCBNDR581, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "ROTOLO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "601-853-2667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "045431",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Ranch Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Mak, M.D.
• Issam Makhoul, MD
• Nadia V. Makkoukdji Depsille, M.D.
• Valeria Malak, M.D.
• Sindhu Janarthanam Malapati, M.D.
• Said Maldonado, MD
• Afaf Aslam Malik, MD
• Ahmar Malik, M.D.
• Nazish Malik, MD
• Shaddy Malik, MD

• Skilled Nursing Facility in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.