Organization
ADVOCATE MEDICAL SUPPORT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET K VANDEEST (OWNER)
(479) 394-1600
Entity
Organization
Contact information
Practice address
300 CRESTWOOD CIR, MENA, AR 71953-5515
(479) 394-1600
(479) 394-1606
Mailing address
300 CRESTWOOD CIR, MENA, AR 71953-5515
(479) 394-1600
(479) 394-1606
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
AR
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/27/2008
Last updated
05/27/2010
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