Provider Demographics
NPI:1639908759
Name:SYNERGY HEALTHCARE LITTLE ROCK LLC
Entity type:Organization
Organization Name:SYNERGY HEALTHCARE LITTLE ROCK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-623-4000
Mailing Address - Street 1:PO BOX 20059
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-0059
Mailing Address - Country:US
Mailing Address - Phone:501-623-4000
Mailing Address - Fax:501-762-8299
Practice Address - Street 1:4024 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5530
Practice Address - Country:US
Practice Address - Phone:501-664-1000
Practice Address - Fax:501-762-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies