Provider Demographics
NPI:1578506432
Name:ARKANSAS ASTHMA & LUNG CENTER INC
Entity Type:Organization
Organization Name:ARKANSAS ASTHMA & LUNG CENTER INC
Other - Org Name:ARKANSAS COMPREHENSIVE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:V
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-580-0458
Mailing Address - Street 1:4 BARBER CT
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6491
Mailing Address - Country:US
Mailing Address - Phone:501-565-5701
Mailing Address - Fax:501-312-4113
Practice Address - Street 1:100 CALELLA RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-3174
Practice Address - Country:US
Practice Address - Phone:501-984-5800
Practice Address - Fax:501-984-5809
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARKANSAS ASTHMA & LUNG CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-14
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR044506227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty