Active Living Medical Supply
Organization Active NPI Oxygen Equipment & Supplies (DME) · Little Rock, AR
NPI 1780860643 · NPPES record last updated Jun 5, 2008
Key facts
- NPI
- 1780860643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oxygen Equipment & Supplies (DME) 332BX2000X
- License
- 800124349 (AR)
- Legal business name
- ACTIVE LIVING MEDICAL SUPPLY
- Practice address
- 11324 Arcade Dr
Suite 24
Little Rock, AR 72212-4074 - Phone
- (501) 379-9217
- Fax
- (501) 379-9218
- NPI assigned
- Jan 10, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Bill Barnes, PTA
- Title
- Coo
- Phone
- (501) 379-9217
National Provider Directory
Locations
11324 Arcade Dr
Ste 24
Little Rock, AR 72212
Phone (501) 379-9217
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 800124349 | AR | Yes |
Addresses
Primary practice location
11324 Arcade Dr
Suite 24
Little Rock, AR 72212-4074
Mailing address
11324 Arcade Dr
Suite 24
Little Rock, AR 72212-4074
Phone (501) 379-9217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167682716 | Medicaid | AR |
Other providers in Little Rock, AR
- Shannon Acker
- Leslie Ackley
- Jennifer Leigh Acklin
- Jordyn Kristin Acoord
- James R Acree
- Andrea Lee Acton
- Josey Acuff
- Zada Virginia Adametz
- Ariel A Adams
- Ashleigh Gaye Adams
All providers in Little Rock, AR · Oxygen Equipment & Supplies (DME) in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.