| Cooper Clinic, Pa | |
|
4600 Towson Ave Ste 101-n Fort Smith AR 72901-7961 | |
| (479) 274-6900 | |
| (479) 648-3951 |
| Full Name | Cooper Clinic, Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 4600 Towson Ave, Fort Smith, Arkansas |
| Authorized Official Name and Position | Curtis D Ralston (CEO) |
| Authorized Official Contact | 4792742000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooper Clinic, Pa Po Box 3528 Fort Smith AR 72913-3528 Ph: (479) 274-2000 | Cooper Clinic, Pa 4600 Towson Ave Ste 101-n Fort Smith AR 72901-7961 Ph: (479) 274-6900 |
| NPI Number | 1104832708 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 09/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104832708 | NPI | - | NPPES |
| 136194002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MC-0254 (Arkansas) | Primary |
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Premise Health - Rheem Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5600 Old Greenwood Rd, Fort Smith, AR 72908 Phone: 479-242-4290 Fax: 479-242-4640 | |
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