Provider Information for 1245319409
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I CARE OF ARKANSAS, INC.
Organization Subpart: NO
NPI: 1245319409
Last Updated: 2020-08-22
Certification Date:
Certification Date:
Details
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NPI | 1245319409 | ||||||||||||||||||||
Enumeration Date | 2006-11-06 | ||||||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||||||
Status | Active | ||||||||||||||||||||
Authorized Official Information | Name: Mr. GENE GRAVES PharnD Title: Owner Phone: 5016870999 | ||||||||||||||||||||
Mailing Address | 1527 S BOWMAN RD SUITE D LITTLE ROCK, AR 72211-4207 United States Phone: 501-687-0999 | Fax:501-687-0879 | ||||||||||||||||||||
Primary Practice Address | 1527 S BOWMAN RD SUITE D LITTLE ROCK, AR 72211-4207 United States Phone: 501-687-0999 | Fax:501-687-0879 | ||||||||||||||||||||
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