Provider Demographics
NPI:1598014664
Name:AIRWAYS MEDICAL, LLC
Entity Type:Organization
Organization Name:AIRWAYS MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCKY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-954-9922
Mailing Address - Street 1:9303 TREASURE HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-6217
Mailing Address - Country:US
Mailing Address - Phone:501-954-9922
Mailing Address - Fax:501-954-8308
Practice Address - Street 1:2125 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6210
Practice Address - Country:US
Practice Address - Phone:501-499-8484
Practice Address - Fax:501-499-8483
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIRWAYS MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00861332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies