Provider Demographics
NPI:1326009853
Name:P&H OSTOMY & HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:P&H OSTOMY & HEALTH SERVICES INC.
Other - Org Name:ARKANSAS MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-897-8588
Mailing Address - Street 1:PO BOX 674553
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-4553
Mailing Address - Country:US
Mailing Address - Phone:501-227-8220
Mailing Address - Fax:501-227-6260
Practice Address - Street 1:1501 N. UNIVERSITY AVENUE
Practice Address - Street 2:STE. 418
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5234
Practice Address - Country:US
Practice Address - Phone:501-227-8220
Practice Address - Fax:501-227-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-02
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00590332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131526716Medicaid
MO620079082Medicaid