Organization
NORTHEAST ARKANSAS SERVICE COMPANY
Active
Other names
Home Medical Equipment and Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
JUNOIR L BRINER (VP OF SUPPORT)
(870) 886-1260
Entity
Organization
Contact information
Practice address
1315 W MAIN ST, WALNUT RIDGE, AR 72476-1430
(870) 886-1260
(870) 886-7525
Mailing address
PO BOX 839, WALNUT RIDGE, AR 72476-0839
(870) 886-1260
(870) 886-7525
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139900716
—
AR
01
—
48842
BLUE CROSS
AR
Enumeration date
05/18/2006
Last updated
07/21/2022
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