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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:

Details

NameValue
NPI1245319409
Enumeration Date2006-11-06
NPI TypeNPI-2 Organization
StatusActive
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
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDAR154296716
MEDICAIDAR154831733
MEDICAIDAR155042407
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies ARMG00604
No 332BP3500X - Durable Medical Equipment & Medical Supplies - Parenteral & Enteral NutritionARMG00604
No 332BX2000X - Durable Medical Equipment & Medical Supplies - Oxygen Equipment & SuppliesARMG00604
No 3336H0001X - Pharmacy - Home Infusion Therapy PharmacyARAR20396