Provider Demographics
NPI:1144273822
Name:BAPTIST HEALTH HOME MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:BAPTIST HEALTH HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:LEANNE
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-250-2463
Mailing Address - Street 1:2026B HIGHWAY 25B
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-6404
Mailing Address - Country:US
Mailing Address - Phone:501-250-2463
Mailing Address - Fax:501-206-0272
Practice Address - Street 1:2026B HIGHWAY 25B
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-6404
Practice Address - Country:US
Practice Address - Phone:501-250-2463
Practice Address - Fax:501-206-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR47844OtherBLUE CROSS BLUE SHIELD
AR47844OtherBLUE CROSS BLUE SHIELD