Provider Demographics
NPI:1245319409
Name:I CARE OF ARKANSAS, INC.
Entity type:Organization
Organization Name:I CARE OF ARKANSAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARND
Authorized Official - Phone:501-687-0999
Mailing Address - Street 1:1527 S BOWMAN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4207
Mailing Address - Country:US
Mailing Address - Phone:501-687-0999
Mailing Address - Fax:501-687-0879
Practice Address - Street 1:1527 S BOWMAN RD
Practice Address - Street 2:SUITE D
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4207
Practice Address - Country:US
Practice Address - Phone:501-687-0999
Practice Address - Fax:501-687-0879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00604332B00000X, 332BP3500X, 332BX2000X
ARAR203963336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5098180001Medicare ID - Type Unspecified