Provider Demographics
NPI:1003024787
Name:CENRTAL MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:CENRTAL MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-224-7744
Mailing Address - Street 1:1200 JOHN BARROW RD
Mailing Address - Street 2:# 304
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6500
Mailing Address - Country:US
Mailing Address - Phone:501-224-7744
Mailing Address - Fax:501-224-7748
Practice Address - Street 1:1200 JOHN BARROW RD
Practice Address - Street 2:# 304
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6500
Practice Address - Country:US
Practice Address - Phone:501-224-7744
Practice Address - Fax:501-224-7748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies