Organization
ORTHOTICS AT HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK K MCNALLY CPO, FAAOP (PRESIDENT)
(501) 803-3555
Entity
Organization
Contact information
Practice address
6001 NIGHTHAWK RD, NORTH LITTLE ROCK, AR 72118-1733
(501) 803-3555
(501) 803-9555
Mailing address
6001 NIGHTHAWK RD, NORTH LITTLE ROCK, AR 72118-1733
(501) 803-3555
(501) 803-9555
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
NONE REQUIRED
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49862
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/01/2006
Last updated
08/22/2020
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