Organization
NEA X-RAY INC
Active
Other names
MEDSOUTH MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT DEAN YOUNGE (OWNER)
(501) 224-0330
Entity
Organization
Contact information
Practice address
7665 COUNTS MASSIE RD, NORTH LITTLE ROCK, AR 72113-6656
(501) 224-0330
(501) 224-0356
Mailing address
7665 COUNTS MASSIE RD, NORTH LITTLE ROCK, AR 72113-6656
(501) 224-0330
(501) 224-0356
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AR
335E00000X
Prosthetic/Orthotic Supplier
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176146716
—
AR
01
—
48390
BLUE CROSS BLUE SHIELD
AR
Enumeration date
11/05/2007
Last updated
08/25/2009
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