Provider Demographics
NPI:1881634244
Name:THE RANGE OF MOTION STORE,INC
Entity Type:Organization
Organization Name:THE RANGE OF MOTION STORE,INC
Other - Org Name:THE RANGE OF MOTION STORE,INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KISHAN
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-664-7788
Mailing Address - Street 1:100 S UNIVERSITY AVE
Mailing Address - Street 2:311
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5213
Mailing Address - Country:US
Mailing Address - Phone:501-664-7788
Mailing Address - Fax:501-664-7789
Practice Address - Street 1:100 S UNIVERSITY AVE
Practice Address - Street 2:311
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5213
Practice Address - Country:US
Practice Address - Phone:501-664-7788
Practice Address - Fax:501-664-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies