Organization
SUMMIT MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN HENRY (OWNER)
(501) 327-5426
Entity
Organization
Contact information
Practice address
170 COMMERCE RD, SUITE 201, CONWAY, AR 72032-7112
(501) 327-5426
(501) 327-5881
Mailing address
PO BOX 2486, CONWAY, AR 72033-2486
(501) 327-5426
(501) 327-5881
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MG00806
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034061
—
LA
01
—
129219
HEALTH PARTNERS
MN
05
—
240067000
—
MN
05
—
432970700
—
MA
01
—
49980
AR BLUE CROSS BLUE SHIELD
AR
05
—
626353304
—
MO
05
—
9061334
—
WA
05
—
DM1270
—
SC
Enumeration date
11/01/2006
Last updated
08/13/2008
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