Provider Demographics
NPI:1477522787
Name:PHELAN INC
Entity Type:Organization
Organization Name:PHELAN INC
Other - Org Name:PHELANS MEDICAL SALES & RENTALS MALVERN HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHELAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PD
Authorized Official - Phone:501-337-9503
Mailing Address - Street 1:999 SCHNEIDER DR
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104
Mailing Address - Country:US
Mailing Address - Phone:501-337-9503
Mailing Address - Fax:501-337-1944
Practice Address - Street 1:999 SCHNEIDER DR
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104
Practice Address - Country:US
Practice Address - Phone:501-337-9503
Practice Address - Fax:501-337-1944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00733332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49460OtherMEDIPAK AR BCBS
AR56468OtherARK MEDICARE
AR49460OtherMEDIPAK AR BCBS