Organization
MARY'S MEDICO RENTAL & SALES, INC.
Active
Other names
Medico Rental & Sales
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEA R MCNARY CHILDRESS (PRESIDENT AND OWNER)
(501) 337-4181
Entity
Organization
Contact information
Practice address
1023 E PAGE AVE, MALVERN, AR 72104-4363
(501) 337-4181
(501) 337-4636
Mailing address
1023 E PAGE AVE, MALVERN, AR 72104-4363
(501) 337-4181
(501) 337-4636
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102639716
—
AR
01
—
1243853
WELLCARE
AR
01
—
47813
BLUE CROSS BLUE SHIELD
AR
01
—
P10001315478
AMBETTER OF ARKANSAS
AR
Enumeration date
07/06/2006
Last updated
08/29/2017
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