Eudora Elementary Clinic | |
566 S Mabry St Eudora AR 71640-2941 | |
(870) 355-2512 | |
(855) 754-0598 |
Full Name | Eudora Elementary Clinic |
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Speciality | Clinic/Center |
Location | 566 S Mabry St, Eudora, Arkansas |
Authorized Official Name and Position | Gary Allan Nichols (CEO) |
Authorized Official Contact | 8709423000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Eudora Elementary Clinic Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Eudora Elementary Clinic 566 S Mabry St Eudora AR 71640-2941 Ph: (870) 355-2512 |
NPI Number | 1619415460 |
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Provider Enumeration Date | 02/01/2017 |
Last Update Date | 07/11/2024 |
Medicare PECOS PAC ID | 5193785590 |
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Medicare Enrollment ID | O20171107000650 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619415460 | NPI | - | NPPES |
223564749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Eudora Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 S Main Street, Eudora, AR 71640 Phone: 870-355-2300 Fax: 870-355-6323 |