Provider Demographics
NPI:1932239340
Name:COUNTY MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:COUNTY MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-268-9200
Mailing Address - Street 1:3005 HAWKINS DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4973
Mailing Address - Country:US
Mailing Address - Phone:501-268-9200
Mailing Address - Fax:501-305-2515
Practice Address - Street 1:713 MARION ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4833
Practice Address - Country:US
Practice Address - Phone:501-268-9200
Practice Address - Fax:501-305-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR149587716Medicaid
AR49882OtherBCBS
AR149587716Medicaid