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4196 Highway 62 412 Ste A Hardy AR 72542-8002 | |
(870) 895-2100 | |
(870) 994-7488 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4196 Highway 62 412 Ste A, Hardy, Arkansas |
Authorized Official Name and Position | Bradley Bibb (CEO) |
Authorized Official Contact | 8709947301 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4196 Highway 62 412 Ste A Hardy AR 72542-8002 Ph: () - | 4196 Highway 62 412 Ste A Hardy AR 72542-8002 Ph: (870) 895-2100 |
NPI Number | 1285183962 |
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Provider Enumeration Date | 09/23/2016 |
Last Update Date | 11/07/2024 |
Medicare PECOS PAC ID | 4789715285 |
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Medicare Enrollment ID | O20161123000159 |
Identifier | Type | State | Issuer |
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1285183962 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |