Basic Information
Provider Information
NPI: 1639180235
EntityType: 2
ReplacementNPI:  
OrganizationName: ARC THERAPY SERVICES LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MEDICAL CITY HEALTHCARE AT HOME
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 PARK PLZ
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372036527
CountryCode: US
TelephoneNumber: 6153449551
FaxNumber:  
Practice Location
Address1: 1255 CORPORATE DR STE 150
Address2:  
City: IRVING
State: TX
PostalCode: 750382562
CountryCode: US
TelephoneNumber: 8179162101
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/10/2006
LastUpdateDate: 08/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STANLEY
AuthorizedOfficialFirstName: GREGG
AuthorizedOfficialMiddleName: ALAN
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 6153449551
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: HEALTH AT HOME-BHS, LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X008028TXY AgenciesHome Health 

No ID Information.


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