Provider Demographics
NPI:1194906362
Name:TOTAL CARE HOME MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:TOTAL CARE HOME MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:870-797-7200
Mailing Address - Street 1:PO BOX 721
Mailing Address - Street 2:
Mailing Address - City:STRONG
Mailing Address - State:AR
Mailing Address - Zip Code:71765-0721
Mailing Address - Country:US
Mailing Address - Phone:870-797-7200
Mailing Address - Fax:870-797-7201
Practice Address - Street 1:9657 STRONG HWY
Practice Address - Street 2:
Practice Address - City:STRONG
Practice Address - State:AR
Practice Address - Zip Code:71765
Practice Address - Country:US
Practice Address - Phone:870-797-7200
Practice Address - Fax:870-797-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR167498716Medicaid
AR6025010001Medicare NSC