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908 Edmonds Ave Mc Crory AR 72101-8073 | |
(870) 347-2534 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 908 Edmonds Ave, Mc Crory, Arkansas |
Authorized Official Name and Position | Steven Collier (CEO) |
Authorized Official Contact | 8703473300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 497 Augusta AR 72006-0497 Ph: () - | 908 Edmonds Ave Mc Crory AR 72101-8073 Ph: (870) 347-2534 |
NPI Number | 1720587306 |
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Provider Enumeration Date | 02/08/2018 |
Last Update Date | 02/16/2018 |
Medicare PECOS PAC ID | 2567370620 |
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Medicare Enrollment ID | O20180830002487 |
Identifier | Type | State | Issuer |
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1720587306 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |