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138 School Rd Rose Bud AR 72137-9339 | |
(501) 556-4344 | |
(501) 556-4347 |
Full Name | |
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Speciality | Clinic/Center |
Location | 138 School Rd, Rose Bud, 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: (870) 347-2534 | 138 School Rd Rose Bud AR 72137-9339 Ph: (501) 556-4344 |
NPI Number | 1548817042 |
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Provider Enumeration Date | 08/20/2019 |
Last Update Date | 06/02/2022 |
Medicare PECOS PAC ID | 2567370620 |
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Medicare Enrollment ID | O20191212002442 |
Identifier | Type | State | Issuer |
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1548817042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |