Provider Demographics
NPI:1720037963
Name:O'BRIAN HEALTHCARE INC
Entity Type:Organization
Organization Name:O'BRIAN HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:O
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-321-9461
Mailing Address - Street 1:117 PIPER ST STE G
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8263
Mailing Address - Country:US
Mailing Address - Phone:501-321-9461
Mailing Address - Fax:501-321-9552
Practice Address - Street 1:1100 N UNIVERSITY AVE STE 66
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6300
Practice Address - Country:US
Practice Address - Phone:501-570-0461
Practice Address - Fax:501-570-0592
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:O'BRIAN HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-06
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00713332B00000X
AR003600332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR161457716Medicaid
AR1267960002Medicare NSC