| Boston Mountain Rural Health Center, Inc | |
|
1103 West Main St Green Forest AR 72638-2810 | |
| (870) 438-6500 | |
| (870) 438-6615 |
| Full Name | Boston Mountain Rural Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1103 West Main St, Green Forest, Arkansas |
| Authorized Official Name and Position | Debbie Ackerson (CEO) |
| Authorized Official Contact | 8704485733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston Mountain Rural Health Center, Inc Po Box 1060 Marshall AR 72650-1060 Ph: (870) 448-5101 | Boston Mountain Rural Health Center, Inc 1103 West Main St Green Forest AR 72638-2810 Ph: (870) 438-6500 |
| NPI Number | 1174857825 |
|---|---|
| Provider Enumeration Date | 09/29/2009 |
| Last Update Date | 01/25/2019 |
| Medicare PECOS PAC ID | 3870401722 |
|---|---|
| Medicare Enrollment ID | O20101221001007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174857825 | NPI | - | NPPES |
| 5B477 | Other | AR | BLUE CROSS |
| 041876 | Other | AR | MEDICARE OSCAR/ CERTIFICATION |
| 187063749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Arkansas) | Primary |
Mercy Clinic Family Medicine-green Forest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Medical Cir, Green Forest, AR 72638 Phone: 870-438-5216 Fax: 870-438-5768 |