Organization
SPARKS MEDICAL FOUNDATION
Active
Other names
RC Goodman Institue for Pain
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA FRIDDLE (SPARKS PROVIDER RELATIONS MANAGER)
(479) 709-7057
Entity
Organization
Contact information
Practice address
1500 DODSON AVE, STE 65, FORT SMITH, AR 72901-5182
(479) 441-5475
(479) 441-4803
Mailing address
PO BOX 1824, FORT SMITH, AR 72902-1824
(479) 709-7399
(479) 709-7053
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4454530047
M-CARE DME
AR
Enumeration date
09/20/2006
Last updated
11/10/2009
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