Organization
UNIVERSAL MEDICAL SUPPLY CORP
Active
Parent organization
UNIVERSAL MEDICAL SUPPLY CORP
Other names
Unimed
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSAL MEDICAL SUPPLY CORP
Authorized official
MR. JERRY DEAN COOK (OWNER)
(479) 936-8487
Entity
Organization
Contact information
Practice address
1626 S 8TH ST, ROGERS, AR 72756-5909
(479) 936-8487
(479) 936-8222
Mailing address
1626 S 8TH ST, ROGERS, AR 72756-5909
(479) 936-8487
(479) 936-8222
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056161
ARKANSAS PHARMACY LICENSE
AR
05
—
131093716
—
AR
05
—
625882709
—
MO
Enumeration date
08/21/2006
Last updated
02/23/2012
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