Provider Demographics
NPI:1841770302
Name:CUFFIE HEALTHCARE LLC
Entity Type:Organization
Organization Name:CUFFIE HEALTHCARE LLC
Other - Org Name:CUFFIE HEALTHCARE SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-394-4600
Mailing Address - Street 1:403 INGRAM BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3403
Mailing Address - Country:US
Mailing Address - Phone:870-394-4600
Mailing Address - Fax:
Practice Address - Street 1:403 INGRAM BLVD
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301
Practice Address - Country:US
Practice Address - Phone:870-394-4600
Practice Address - Fax:870-551-3724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 291U00000X, 343900000X, 3747P1801X
AR251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR224967774Medicaid
AR226400736Medicaid
AR224968767Medicaid
AR226400732Medicaid