Family Medical Care, Pa | |
2225 Highway 110 W Heber Springs AR 72543-3404 | |
(501) 362-0048 | |
(501) 362-8815 |
Full Name | Family Medical Care, Pa |
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Speciality | Family Medicine |
Location | 2225 Highway 110 W, Heber Springs, Arkansas |
Authorized Official Name and Position | Granville Leroy Vaughan (OWNER/CEO) |
Authorized Official Contact | 5013620048 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Medical Care, Pa Po Box 1018 2225 Highway 110 West Heber Springs AR 72543-1018 Ph: (501) 362-0048 | Family Medical Care, Pa 2225 Highway 110 W Heber Springs AR 72543-3404 Ph: (501) 362-0048 |
NPI Number | 1255371753 |
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Provider Enumeration Date | 06/07/2006 |
Last Update Date | 07/30/2008 |
Medicare PECOS PAC ID | 2668668831 |
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Medicare Enrollment ID | O20101130000738 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255371753 | NPI | - | NPPES |
149045002 | Medicaid | AR | |
080191764 | Other | AR | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | C7548 (Arkansas) | Primary |
Provider Name | Granville L Vaughan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972582534 PECOS PAC ID: 4284820457 Enrollment ID: I20101130000790 |
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