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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT CARY YARBROUGH (OWNER/MANAGING MEMBER)
(501) 590-0439
Entity
Organization

Contact information

Practice address
2195 PEYTON ST, WARD, AR 72176-8563
(501) 941-2949
(501) 941-2952
Mailing address
6929 JFK BLVD # 20-287, NORTH LITTLE ROCK, AR 72116-5312
(501) 941-2949
(501) 941-2952

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MG01445
AR
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
MG01445
AR
335E00000X
Prosthetic/Orthotic Supplier
MG01445
AR

Other

Enumeration date
07/03/2013
Last updated
09/30/2013
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