Provider Demographics
NPI:1649518200
Name:PREVENTION PLUS, INC.
Entity type:Organization
Organization Name:PREVENTION PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGERF
Authorized Official - Prefix:MS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-762-6002
Mailing Address - Street 1:1204 SE 28TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3881
Mailing Address - Country:US
Mailing Address - Phone:479-268-3477
Mailing Address - Fax:479-268-3478
Practice Address - Street 1:1204 SE 28TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3881
Practice Address - Country:US
Practice Address - Phone:479-268-3477
Practice Address - Fax:479-268-3478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty