Provider Demographics
NPI:1376726968
Name:SMITH FS2 INC
Entity Type:Organization
Organization Name:SMITH FS2 INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:501-223-3383
Mailing Address - Street 1:301 S BOWMAN RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3431
Mailing Address - Country:US
Mailing Address - Phone:501-223-3383
Mailing Address - Fax:501-223-5406
Practice Address - Street 1:3301 S WALTON BLVD
Practice Address - Street 2:SUITE 21
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72716-0001
Practice Address - Country:US
Practice Address - Phone:479-273-1600
Practice Address - Fax:479-273-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR6108750001Medicare NSC