Organization
TERESA WHITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA ANN WHITE (OWNER)
(870) 352-3338
Entity
Organization
Contact information
Practice address
1606 WEST 4TH STREET, FORDYCE, AR 71742-1904
(870) 352-3338
(870) 352-3368
Mailing address
1606 WEST 4TH STREET, FORDYCE, AR 71742-1904
(870) 352-3338
(870) 352-3368
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000608
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49909
AR BCBS
AR
Enumeration date
07/07/2005
Last updated
08/22/2020
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