Provider Demographics
NPI:1053431569
Name:JOSHUA MEDICAL LINK CORPORATION
Entity type:Organization
Organization Name:JOSHUA MEDICAL LINK CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNLEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-614-9711
Mailing Address - Street 1:1100 N UNIVERSITY AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6343
Mailing Address - Country:US
Mailing Address - Phone:501-614-9711
Mailing Address - Fax:501-614-9713
Practice Address - Street 1:1100 N UNIVERSITY AVE
Practice Address - Street 2:STE 130
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6343
Practice Address - Country:US
Practice Address - Phone:501-614-9711
Practice Address - Fax:501-614-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR6000780001Medicare NSC