Provider Demographics
NPI:1619921871
Name:A&D HEALTHCARE
Entity Type:Organization
Organization Name:A&D HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-507-2561
Mailing Address - Street 1:PO BOX 2597
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-2597
Mailing Address - Country:US
Mailing Address - Phone:901-507-2561
Mailing Address - Fax:901-507-2569
Practice Address - Street 1:328 DILLARD ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-3260
Practice Address - Country:US
Practice Address - Phone:870-630-1898
Practice Address - Fax:870-630-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1219600002Medicare ID - Type UnspecifiedFORREST CITY