Organization
PAMELA L COOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA L COOK (CPED)
(479) 890-5933
Entity
Organization
Contact information
Practice address
805 E MAIN ST, RUSSELLVILLE, AR 72801-5249
(479) 890-5933
(479) 890-9373
Mailing address
805 E MAIN ST, RUSSELLVILLE, AR 72801-5249
(479) 890-5933
(479) 890-9373
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146651716
—
AR
Enumeration date
06/23/2005
Last updated
12/26/2007
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