Benton Neurocare Inc. | |
811 Se 28th St Ste 5 Bentonville AR 72712-4294 | |
(479) 254-9761 | |
(479) 254-9732 |
Full Name | Benton Neurocare Inc. |
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Speciality | Clinic/Center |
Location | 811 Se 28th St Ste 5, Bentonville, Arkansas |
Authorized Official Name and Position | Ahmad Al-khatib (PRESIDENT) |
Authorized Official Contact | 4792549761 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Benton Neurocare Inc. 811 Se 28th St Ste 5 Bentonville AR 72712-4294 Ph: (479) 254-9761 | Benton Neurocare Inc. 811 Se 28th St Ste 5 Bentonville AR 72712-4294 Ph: (479) 254-9761 |
NPI Number | 1063680973 |
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Provider Enumeration Date | 02/13/2008 |
Last Update Date | 02/13/2008 |
Medicare PECOS PAC ID | 9739255027 |
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Medicare Enrollment ID | O20080910000697 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063680973 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Ahmad Al-khatib |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1548273394 PECOS PAC ID: 7315979655 Enrollment ID: I20080213000091 |
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