Provider Demographics
NPI:1699333104
Name:CENTRAL ARKANSAS INFUSION SPECIALIST LLC
Entity type:Organization
Organization Name:CENTRAL ARKANSAS INFUSION SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIKHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-920-2505
Mailing Address - Street 1:2613 JOHNSWOOD VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-2759
Mailing Address - Country:US
Mailing Address - Phone:501-920-2505
Mailing Address - Fax:
Practice Address - Street 1:8907 KANIS RD STE 403
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6400
Practice Address - Country:US
Practice Address - Phone:501-217-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy