Individual
CASSANDRA Y ROSSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8404 RUSSWOOD LN W, MABELVALE, AR 72103-4283
(732) 300-6889
Mailing address
PO BOX 46323, LITTLE ROCK, AR 72214-6323
(732) 300-6889
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
AR
171WH0202X
Home Modifications Contractor
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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