| Asu Mid South Health Center | |
|
2000 W. Broadway St. Trlr 1 West Memphis AR 72301-3829 | |
| (870) 735-3842 | |
| Not Available |
| Full Name | Asu Mid South Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2000 W. Broadway St. Trlr 1, West Memphis, Arkansas |
| Authorized Official Name and Position | Susan Ward-jones (CEO) |
| Authorized Official Contact | 8707353842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asu Mid South Health Center 900 N. 7th St West Memphis AR 72301-2001 Ph: (870) 735-3842 | Asu Mid South Health Center 2000 W. Broadway St. Trlr 1 West Memphis AR 72301-3829 Ph: (870) 735-3842 |
| NPI Number | 1427572213 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1052390390 |
|---|---|
| Medicare Enrollment ID | O20170818000248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427572213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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