Provider Demographics
NPI:1982673968
Name:PATIENT FIRST HOME MEDICAL
Entity Type:Organization
Organization Name:PATIENT FIRST HOME MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-279-0909
Mailing Address - Street 1:811 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6889
Mailing Address - Country:US
Mailing Address - Phone:501-279-0909
Mailing Address - Fax:501-279-2547
Practice Address - Street 1:811 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6857
Practice Address - Country:US
Practice Address - Phone:501-279-0909
Practice Address - Fax:501-279-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49387OtherBCBS
1160970001Medicare NSC