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Organization
PRO-MED OF THE JONESBORO, INC
Active
Organization
PRO-MED OF THE JONESBORO, INC
Active
Parent organization
PRO-MED OF JONESBORO, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRO-MED OF JONESBORO, INC
Authorized official
MR. GREG BROOKS (OWNER)
(870) 931-0022
Entity
Organization
Contact information
Practice address
2379 HIGHWAY 62 412, SUITE L, HIGHLAND, AR 72542-9393
(870) 856-3300
Mailing address
300 CARSON ST, SUITE 103, JONESBORO, AR 72401-3104
(870) 931-9565
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145632716
—
AR
01
—
48932
B/C B/S OF ARKANSAS
AR
Enumeration date
01/03/2008
Last updated
12/10/2008
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