Provider Demographics
NPI:1336226612
Name:SPECTRUM INC
Entity Type:Organization
Organization Name:SPECTRUM INC
Other - Org Name:AFFORDABLE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-327-9500
Mailing Address - Street 1:1272 HARKRIDER ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4263
Mailing Address - Country:US
Mailing Address - Phone:501-327-9500
Mailing Address - Fax:501-329-7201
Practice Address - Street 1:1272 HARKRIDER ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4263
Practice Address - Country:US
Practice Address - Phone:501-327-9500
Practice Address - Fax:501-329-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49904OtherBCBS
AR49904OtherBCBS