Lakeview Satellite Clinic | |
14264 Highway 44 Wabash AR 72389 | |
(870) 295-5225 | |
(870) 295-6900 |
Full Name | Lakeview Satellite Clinic |
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Speciality | Clinic/Center |
Location | 14264 Highway 44, Wabash, Arkansas |
Authorized Official Name and Position | Ossie M Hall (CASHIER/BILLING SUPERVISOR) |
Authorized Official Contact | 8702955225 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lakeview Satellite Clinic Po Box 669 Marianna AR 72360-0669 Ph: (870) 295-5225 | Lakeview Satellite Clinic 14264 Highway 44 Wabash AR 72389 Ph: (870) 295-5225 |
NPI Number | 1356359442 |
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Provider Enumeration Date | 08/04/2006 |
Last Update Date | 03/02/2021 |
Medicare PECOS PAC ID | 8921917204 |
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Medicare Enrollment ID | O20100818001076 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356359442 | NPI | - | NPPES |
125274749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |