Provider Demographics
NPI:1407838717
Name:ASSIST MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:ASSIST MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-376-1975
Mailing Address - Street 1:PO BOX 1033
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203-1033
Mailing Address - Country:US
Mailing Address - Phone:501-376-1975
Mailing Address - Fax:501-666-7500
Practice Address - Street 1:100 MORGAN KEEGAN DR
Practice Address - Street 2:SUITE 120
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-2286
Practice Address - Country:US
Practice Address - Phone:501-666-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BN1400X
AR332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49848OtherABCBS PROVIDER NUMBER
AR4385010001Medicare NSC