Organization
FIRSTLIGHT HOME CARE NWA
Active
Other names
S&R Arkansas LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GANNON RANDOLPH M.D. (OWNER)
(479) 899-6955
Entity
Organization
Contact information
Practice address
1400 W WALNUT ST, SUITE #106, ROGERS, AR 72756-3339
(479) 899-6955
(479) 270-1612
Mailing address
1400 W WALNUT ST, SUITE #106, ROGERS, AR 72756-3339
(479) 899-6955
(479) 270-1612
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
AR
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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