Provider Demographics
NPI:1184635963
Name:ACCESSIBILITY SPECIALTIES INC
Entity Type:Organization
Organization Name:ACCESSIBILITY SPECIALTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-312-1000
Mailing Address - Street 1:PO BOX 45875
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72214-5875
Mailing Address - Country:US
Mailing Address - Phone:501-312-1000
Mailing Address - Fax:501-312-1100
Practice Address - Street 1:1920 JOHN BARROW RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1448
Practice Address - Country:US
Practice Address - Phone:501-312-1000
Practice Address - Fax:501-312-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225CA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49936OtherAR BLUE CROSS BLUESHIELD
AR142516772OtherMEDICAID WAIVER
AR156245716Medicaid
AR1236540001Medicare NSC