# TIPPIN SURGICAL SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427139567
- **Authorized official:** MR. BARRY TIPPIN (OWNER)
- **Authorized official phone:** (479) 489-5237

## Contact information

- **Practice address:** 502 WEST PENNINGTON STREET, OLA, AR 72853
- **Practice address phone:** (479) 489-5237
- **Mailing address:** PO BOX 249, OLA, AR 72853-0249
- **Mailing address phone:** (479) 489-5237
- **Mailing address fax:** (479) 489-5714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 0339347500 | AR | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 06/17/2008