| Organization Name: | IVORY DURABLE MEDICAL EQUIPMEMT |
| NPI Number: | 1639315633 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM IVORY (OWNER) |
| Mailing Address: | 201 W Broadway St Ste G19 N Little Rock |
| State: | AR US |
| Postal Code: | 721145541 |
| Phone Number: | 5013743131 |
| Fax Number: | |
| NPI Enumeration Date: | 12/21/2008 |
| NPI Last Update Date: | 12/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |