| Organization Name: | PRO-MED MEDICAL SUPPLY |
| NPI Number: | 1023177813 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SLADE BROWN (OWNER) |
| Mailing Address: | 1313 N Hills Blvd Suite 301 North Little Rock |
| State: | AR US |
| Postal Code: | 721143757 |
| Phone Number: | 5013532610 |
| Fax Number: | 5013532621 |
| NPI Enumeration Date: | 12/07/2006 |
| NPI Last Update Date: | 09/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 7573 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |