Organization
TIPPIN SURGICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY TIPPIN (OWNER)
(479) 489-5237
Entity
Organization
Contact information
Practice address
502 WEST PENNINGTON STREET, OLA, AR 72853
(479) 489-5237
Mailing address
PO BOX 249, OLA, AR 72853-0249
(479) 489-5237
(479) 489-5714
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
0339347500
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122975741
—
AR
Enumeration date
10/17/2006
Last updated
06/17/2008
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