Organization
EXTENDI-CARE, INC.
Active
Other names
Lakeside DME
Organization subpart
No
Provider details
NPI number
Authorized official
A BRANDON ADAMS (PRESIDENT)
(501) 548-0190
Entity
Organization
Contact information
Practice address
824 SALEM RD, STE. 240, CONWAY, AR 72034-4821
(501) 548-0190
(501) 327-5533
Mailing address
824 SALEM RD, STE. 240, CONWAY, AR 72034-4821
(501) 548-0190
(501) 327-5533
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
005155
AR
Other
Enumeration date
09/22/2005
Last updated
12/03/2007
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