Provider Demographics
NPI:1639165848
Name:MEDICAL ARTS, INC.
Entity Type:Organization
Organization Name:MEDICAL ARTS, INC.
Other - Org Name:MEDICAL ARTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:479-443-2102
Mailing Address - Street 1:2515 E HUNTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-7329
Mailing Address - Country:US
Mailing Address - Phone:479-443-2102
Mailing Address - Fax:479-443-3412
Practice Address - Street 1:2515 E HUNTSVILLE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-7329
Practice Address - Country:US
Practice Address - Phone:479-443-2102
Practice Address - Fax:479-443-3412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142595716Medicaid
AR142595716Medicaid
1321760001Medicare NSC