Provider Demographics
NPI:1447387014
Name:SOUTHWEST ARKANSAS FURNITURE
Entity Type:Organization
Organization Name:SOUTHWEST ARKANSAS FURNITURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BLAKELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-845-3767
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-0066
Mailing Address - Country:US
Mailing Address - Phone:870-845-3767
Mailing Address - Fax:870-845-1100
Practice Address - Street 1:302 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-2004
Practice Address - Country:US
Practice Address - Phone:870-845-3767
Practice Address - Fax:870-845-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty