Provider Demographics
NPI:1013201235
Name:C.B.F.M.C. INC
Entity Type:Organization
Organization Name:C.B.F.M.C. INC
Other - Org Name:NORTH CENTRAL IV & RESPIRATORY SPECIALISTS, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SAMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-932-0150
Mailing Address - Street 1:202 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3102
Mailing Address - Country:US
Mailing Address - Phone:870-932-0150
Mailing Address - Fax:870-932-0870
Practice Address - Street 1:202 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3102
Practice Address - Country:US
Practice Address - Phone:870-932-0150
Practice Address - Fax:870-932-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR190150733Medicaid
AR6588440001Medicare NSC