Organization
PKC MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANA CARRUTH RN (OWNER)
(479) 968-1777
Entity
Organization
Contact information
Practice address
915 W B ST, RUSSELLVILLE, AR 72801-3501
(479) 968-1777
(479) 967-1111
Mailing address
915 W B ST, RUSSELLVILLE, AR 72801-3501
(479) 968-1777
(479) 967-1111
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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