Grace & Hope Medical Center Pllc | |
5701 Euper Ln Ste B Fort Smith AR 72903-3255 | |
(479) 769-2519 | |
(501) 510-5917 |
Full Name | Grace & Hope Medical Center Pllc |
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Speciality | Internal Medicine |
Location | 5701 Euper Ln Ste B, Fort Smith, Arkansas |
Authorized Official Name and Position | Gina Vargas (OWNER) |
Authorized Official Contact | 4797692519 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grace & Hope Medical Center Pllc 2916 Kells Abbey Fort Smith AR 72908-9317 Ph: (479) 769-2519 | Grace & Hope Medical Center Pllc 5701 Euper Ln Ste B Fort Smith AR 72903-3255 Ph: (479) 769-2519 |
NPI Number | 1205595378 |
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Provider Enumeration Date | 12/15/2021 |
Last Update Date | 12/15/2021 |
Medicare PECOS PAC ID | 2163813064 |
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Medicare Enrollment ID | O20220104001848 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205595378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Gina Marie Vargas |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1720218894 PECOS PAC ID: 1850557414 Enrollment ID: I20150914000781 |
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