Provider Demographics
NPI:1972369346
Name:PALCO, INC.
Entity type:Organization
Organization Name:PALCO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALADINO
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:501-604-9936
Mailing Address - Street 1:PO BOX 13260
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-0260
Mailing Address - Country:US
Mailing Address - Phone:501-604-9936
Mailing Address - Fax:
Practice Address - Street 1:501 MILLWOOD CIR STE A
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6304
Practice Address - Country:US
Practice Address - Phone:501-604-9936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage