| |
5830 Highway 5 Cabot AR 72023-7328 | |
(501) 941-1376 | |
(501) 941-2793 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 5830 Highway 5, Cabot, Arkansas |
Authorized Official Name and Position | Steven Collier (CEO) |
Authorized Official Contact | 8703472534 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
117 S 2nd St Po Box 497 Augusta AR 72006-2309 Ph: (870) 347-2534 | 5830 Highway 5 Cabot AR 72023-7328 Ph: (501) 941-1376 |
NPI Number | 1679994412 |
---|---|
Provider Enumeration Date | 12/20/2013 |
Last Update Date | 01/20/2021 |
Medicare PECOS PAC ID | 2567370620 |
---|---|
Medicare Enrollment ID | O20140306000135 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679994412 | NPI | - | NPPES |
201990749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Jerry L Harvey, Do, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15361 Highway 5, Suite E, Cabot, AR 72023 Phone: 501-605-9355 | |