Provider Demographics
NPI:1780649061
Name:MEDICAL NECESSITIES OF CABOT, INC
Entity Type:Organization
Organization Name:MEDICAL NECESSITIES OF CABOT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-941-5401
Mailing Address - Street 1:1212 SOUTH 2ND
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023
Mailing Address - Country:US
Mailing Address - Phone:501-941-5401
Mailing Address - Fax:501-605-0178
Practice Address - Street 1:1212 SOUTH 2ND
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023
Practice Address - Country:US
Practice Address - Phone:501-941-5401
Practice Address - Fax:501-605-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49779OtherARKANSAS BCBS
AR49779OtherARKANSAS BCBS
AR49779OtherARKANSAS BCBS