Organization
MAGNIFIQUE, INC.
Active
Other names
SUPREME MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARLA REGINA THOMAS RN (MANAGER)
(870) 534-2224
Entity
Organization
Contact information
Practice address
730 S BLAKE ST, PINE BLUFF, AR 71603-1822
(870) 534-2224
(870) 534-1226
Mailing address
730 S BLAKE ST, PINE BLUFF, AR 71603-1822
(870) 534-2224
(870) 534-1226
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AR
Other
Enumeration date
06/18/2006
Last updated
08/22/2020
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