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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:

PrimaryCodeCategory/DescriptionStateLicense Number
X3336L0003XSuppliers
Pharmacy
Long Term Care Pharmacy
X333600000XSuppliers
Pharmacy
ARAR20528

Other Provider Identifiers:

IssuerNumberStateType
OTHER ID NUMBER-COMMERCIAL NUMBER042235701
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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