Provider Demographics
NPI:1407053283
Name:EDINGTON ENTERPRISES INC
Entity Type:Organization
Organization Name:EDINGTON ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:EDINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:870-424-9292
Mailing Address - Street 1:504 POWERS ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2925
Mailing Address - Country:US
Mailing Address - Phone:870-424-9292
Mailing Address - Fax:870-425-5254
Practice Address - Street 1:504 POWERS ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2925
Practice Address - Country:US
Practice Address - Phone:870-424-9292
Practice Address - Fax:870-425-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1611225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty