Organization
MID SOUTH MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT D BETHELL JR. (OWNER)
(870) 238-4242
Entity
Organization
Contact information
Practice address
501 FALLS BLVD S, WYNNE, AR 72396-3513
(870) 238-4242
(870) 238-4035
Mailing address
PO BOX 1067, WYNNE, AR 72396-1067
(870) 238-4242
(870) 238-4035
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143588716
—
AR
01
—
49769
BC BS
AR
Enumeration date
01/02/2007
Last updated
07/28/2008
Update your record
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