Local City Search for Medical Equipment Suppliers PEDIATRIC NUTRITION PROV OF AR
Medical Equipment Supplier Yellow Pages
Benton, Arkansas
Provider NPI: 1477598795
Organization Information:Organization Name: PEDIATRIC NUTRITION PROV OF AR
Practice Location:
920 EDISON AVE STE 9 BENTON, AR 72015 US
Tel: 501-315-7337 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
920 EDISON AVE STE 9 BENTON, AR 72015 US
Tel: 501-315-7337 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| X | 3336L0003X | Suppliers Pharmacy Long Term Care Pharmacy | ||
| X | 333600000X | Suppliers Pharmacy | AR | AR20528 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0422357 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
