Self Reliance LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SELF RELIANCE LLC

Practice address

500 S University Ave
Suite a-14
Little Rock, AR 72205-5302

Phone

(501) 671-6200

Fax

(501) 671-6205

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Magomed Khaidakov

Title

President

Phone

(501) 658-8057

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1851551386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE A-14",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-671-6200",
            "fax_number": "501-671-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE A-14",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-671-6200",
            "fax_number": "501-671-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF RELIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "KHAIDAKOV",
        "authorized_official_first_name": "MAGOMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-658-8057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175796716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleb Andrew Seiter, CRNA
• Mary E Selanders
• Micheal Lee Selby, M.D.
• Select Specialty Hospital - Little Rock Inc
• Select Specialty Hospital - Little Rock/BMC Inc
• Elizabeth Sellars, M.D.
• Cristy Sellers, RD
• Dominique Sellers
• Matthew Allen Sellers, MD
• Lynnah Kay Selman, MD

• Durable Medical Equipment & Medical Supplies in Little Rock, AR
• Providers in Little Rock, 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 31, 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.