Provider Demographics
NPI:1427321835
Name:MEDICAL SOLUTIONS OF ARKANSAS, LLC
Entity type:Organization
Organization Name:MEDICAL SOLUTIONS OF ARKANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-897-2576
Mailing Address - Street 1:3675 NEW GETWELL RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-6053
Mailing Address - Country:US
Mailing Address - Phone:870-336-3208
Mailing Address - Fax:870-336-3210
Practice Address - Street 1:3675 NEW GETWELL RD
Practice Address - Street 2:SUITE 14
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6053
Practice Address - Country:US
Practice Address - Phone:870-336-3208
Practice Address - Fax:870-336-3210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL SOLUTIONS OF ARKANSAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164325716Medicaid
AR5832770001Medicare NSC