institution
Pediatric Nutrition Provider Of Arkansas
Durable Medical Equipment & Medical Supplies in Benton, Arkansas
NPI 1265569453

Pediatric Nutrition Provider Of Arkansas is a Durable Medical Equipment & Medical Supplies based in Benton, AR. Pediatric Nutrition Provider Of Arkansas practices in Benton, AR. The NPI Number for Pediatric Nutrition Provider Of Arkansas is 1265569453 and holds a License No. MG00511 (Arkansas).

The current practice location address for Pediatric Nutrition Provider Of Arkansas is 920 Edison Ave, Benton, AR and can be reached out via phone at 501-315-7337. You can also correspond with Pediatric Nutrition Provider Of Arkansas through the mailing address at 920 EDISON AVE, BENTON, AR - 72015-4502 (mailing address contact number: 501-315-7337).

Location: 920 Edison Ave, Benton, AR, 72015-4502
institution
Provider Profile Details
NPI Number
1265569453
Provider Name
Pediatric Nutrition Provider Of Arkansas
Credential
Provider Entity Type
Organization
Address
920 Edison Ave, Benton, AR, 72015-4502
Phone Number
501-315-7337
Fax Number
Provider Enumeration Date
02/27/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
49908 01 AR BCBS
institution
Provider Business Practice Location Address Details
Address
920 Edison Ave
City
State
Zip
72015-4502
Phone Number
501-315-7337
Fax Number
person
Provider Business Mailing Address Details
Address
920 Edison Ave
City
State
Zip
72015-4502
Phone Number
501-315-7337
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
License No.
MG00511 (Arkansas)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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